20D0702786 CLIA NUMBER - MAINEHEALTH PRIMARY CARE FAMILY MEDICINE PORTLAND

Laboratory Demographics

  • CLIA Code: 20D0702786
  • Facility Name: MAINEHEALTH PRIMARY CARE FAMILY MEDICINE PORTLAND
  • Facility Address: 272 CONGRESS STREET
    PORTLAND, ME
    ZIP 04101
  • Facility Phone: 207 874-2466
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ADRIANA ISACKE
  • NPI Number: 1639194509
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 20D0702786
LAB Type Physician Office
Facility Name MAINEHEALTH PRIMARY CARE FAMILY MEDICINE PORTLAND
Street 272 CONGRESS STREET
City PORTLAND
State ME
ZIP 04101
Phone 207 874-2466
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/12/2024
Certificate Expiration Date 10/11/2026
Facility Type Physician Office
Lab Director ADRIANA ISACKE

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