02D2276987 CLIA NUMBER - ALASKA INTERIOR SURGICAL CENTER, LLC

Laboratory Demographics

  • CLIA Code: 02D2276987
  • Facility Name: ALASKA INTERIOR SURGICAL CENTER, LLC
  • Facility Address: 2485 CHIEF WILLIAM DR, #100
    FAIRBANKS, AK
    ZIP 99709
  • Facility Phone: 907 416-5611
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. ERICK G. MARTELL
  • NPI Number: 1285330332
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 02D2276987
LAB Type Ambulatory Surgery Center
Facility Name ALASKA INTERIOR SURGICAL CENTER, LLC
Street 2485 CHIEF WILLIAM DR, #100
City FAIRBANKS
State AK
ZIP 99709
Phone 907 416-5611
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2025
Certificate Expiration Date 2/16/2027
Facility Type Ambulatory Surgery Center
Lab Director DR. ERICK G. MARTELL

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This page was last updated on: 9/29/2025