02D2296070 CLIA NUMBER - TRAILHEAD MEDICAL CARE

Laboratory Demographics

  • CLIA Code: 02D2296070
  • Facility Name: TRAILHEAD MEDICAL CARE
  • Facility Address: 729 NORTHWAY DR
    ANCHORAGE, AK
    ZIP 99508
  • Facility Phone: 907 644-3239
  • Facility Type: Other - NP FAMILY CLINIC
  • Facility Type: Waiver
  • Lab Director: TIFFANY J. TATE
  • NPI Number: 1275307449
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 02D2296070
LAB Type Other - NP FAMILY CLINIC
Facility Name TRAILHEAD MEDICAL CARE
Street 729 NORTHWAY DR
City ANCHORAGE
State AK
ZIP 99508
Phone 907 644-3239
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2023
Certificate Expiration Date 12/19/2025
Facility Type Other - NP FAMILY CLINIC
Lab Director TIFFANY J. TATE

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