20D0090508 CLIA NUMBER - SKOWHEGAN FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 20D0090508

Facility Name: SKOWHEGAN FAMILY MEDICINE

Facility Address:
46 FAIRVIEW AVE, SUITE 334
SKOWHEGAN, ME
ZIP 04976
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Facility Phone Number: 207 474-6201

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1538146402

Taxonomy: 2085R0202X - Radiology
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

CLIA Record

Field Name	Field Value
CLIA Number	20D0090508
LAB Type	Physician Office
Facility Name	SKOWHEGAN FAMILY MEDICINE
Street	46 FAIRVIEW AVE, SUITE 334
City	SKOWHEGAN
State	ME
ZIP	04976
Phone	207 474-6201
CertificateType	3
CertificateEffectiveDate	8/14/2022
CertificateExpirationDate	8/13/2024
FacilityType	PPMP

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