20D0090256 CLIA NUMBER - MAINEGENERAL DBA WATERVILLE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 20D0090256
  • Facility Name: MAINEGENERAL DBA WATERVILLE PEDIATRICS
  • Facility Address: 295C KENNEDY MEMORIAL DRIVE SUITE 1
    WATERVILLE, ME
    ZIP 04901
  • Facility Phone: 207 873-5437
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MELISSA TAYLOR
  • NPI Number: 1790871994
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 20D0090256
LAB Type Physician Office
Facility Name MAINEGENERAL DBA WATERVILLE PEDIATRICS
Street 295C KENNEDY MEMORIAL DRIVE SUITE 1
City WATERVILLE
State ME
ZIP 04901
Phone 207 873-5437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2024
Certificate Expiration Date 3/31/2026
Facility Type Physician Office
Lab Director DR. MELISSA TAYLOR

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