CLIA lab
CLIA 02D2103660: Legacy Health Clinic, LLC
Ketchikan, AK. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 02D2103660 belongs to Legacy Health Clinic, LLC in Ketchikan, AK.
Certificate of Waiver, effective October 16, 2025, expires October 15, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- October 16, 2025
- Certificate expiration
- October 15, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 16, 2015
- Facility type
- Other practitioner
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 02D2103660
- Lab name
- Legacy Health Clinic, LLC
- Address
- 3524 Tongass Avenue, Ketchikan, AK 99901
- Phone
- (907) 225-6355
- Fax
- (907) 225-7095
Annual test volume the lab reported
- Waived tests
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Ketchikan, AK
- Comprehensive Addiction ServicesCertificate of Waiver, Other02D2344802
- Creekside Family Health Clinic, IncCertificate of Waiver, Physician office02D1088324
- Ketchikan Fire DepartmentCertificate of Waiver, Mobile lab02D0672646
- Ketchikan Functional MedicineCertificate of Waiver, Other practitioner02D2347580
- Ketchikan Indian CommunityCertificate of Waiver, Community clinic02D2236636
- Ketchikan Indian Community Tribal Health ClinicCertificate of Accreditation, Federally qualified health center02D0934737
- New Horizons Transitional Care UnitCertificate of Waiver, Skilled nursing or nursing facility02D0641450
- Northway Family HealthcareCertificate of Waiver, Physician office02D2087528
- Peacehealth Ketchikan Medical CenterCertificate of Accreditation, Hospital02D0641454
- Peacehealth Ketchikan Medical CenterCertificate for Provider-Performed Microscopy Procedures, Rural health clinic02D2026103
Related
Questions
What is the CLIA number for Legacy Health Clinic, LLC in Ketchikan?
02D2103660, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Legacy Health Clinic, LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 02D2103660 expire?
The CMS file lists October 15, 2027 as the certificate expiration date; the certificate took effect October 16, 2025.