02D2305636 CLIA NUMBER - RAVENCREST MEDICAL

Laboratory Demographics

  • CLIA Code: 02D2305636
  • Facility Name: RAVENCREST MEDICAL
  • Facility Address: 35670 KENAI SPUR HWY, STE 102
    SOLDOTNA, AK
    ZIP 99669
  • Facility Phone: 907 921-2221
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DANNA MOISII
  • NPI Number: 1033958491
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 02D2305636
LAB Type Practitioner Other
Facility Name RAVENCREST MEDICAL
Street 35670 KENAI SPUR HWY, STE 102
City SOLDOTNA
State AK
ZIP 99669
Phone 907 921-2221
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/4/2024
Certificate Expiration Date 6/3/2026
Facility Type Practitioner Other
Lab Director DANNA MOISII

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