20D0003080 CLIA NUMBER - PLEASANT POINT HEALTH CENTER

Laboratory Demographics

CLIA Number: 20D0003080

Facility Name: PLEASANT POINT HEALTH CENTER

Facility Address:
11 BACK RD
PERRY, ME
ZIP 04667
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Facility Phone Number: 207 853-0644

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1760474613

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	20D0003080
LAB Type	Federally Qualified Health Center
Facility Name	PLEASANT POINT HEALTH CENTER
Street	11 BACK RD
City	PERRY
State	ME
ZIP	04667
Phone	207 853-0644
CertificateType	4
CertificateEffectiveDate	6/5/2022
CertificateExpirationDate	6/4/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024