20D0090304 CLIA NUMBER - WATERVILLE FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 20D0090304
  • Facility Name: WATERVILLE FAMILY PRACTICE
  • Facility Address: 31 FRONT STREET
    WATERVILLE, ME
    ZIP 04901
  • Facility Phone: 207 873-1181
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JULIE J. PHELPS
  • NPI Number: 1386634707
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 20D0090304
LAB Type Physician Office
Facility Name WATERVILLE FAMILY PRACTICE
Street 31 FRONT STREET
City WATERVILLE
State ME
ZIP 04901
Phone 207 873-1181
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 3/7/2025
Certificate Expiration Date 3/6/2027
Facility Type Physician Office
Lab Director JULIE J. PHELPS

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This page was last updated on: 3/20/2025