20D0709484 CLIA NUMBER - CONCENTRA URGENT CARE - PORTLAND

Laboratory Demographics

  • CLIA Code: 20D0709484
  • Facility Name: CONCENTRA URGENT CARE - PORTLAND
  • Facility Address: 85 WESTERN AVE
    SOUTH PORTLAND, ME
    ZIP 04106
  • Facility Phone: 207 774-7751
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JOSEPH CASTORINA MD
  • NPI Number: 1053680876
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 20D0709484
LAB Type Physician Office
Facility Name CONCENTRA URGENT CARE - PORTLAND
Street 85 WESTERN AVE
City SOUTH PORTLAND
State ME
ZIP 04106
Phone 207 774-7751
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director JOSEPH CASTORINA MD

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