20D0864869 CLIA NUMBER - PORTLAND ENDOSCOPY CENTER

Laboratory Demographics

  • CLIA Code: 20D0864869
  • Facility Name: PORTLAND ENDOSCOPY CENTER
  • Facility Address: 161 MARGINAL WAY ATTN LESLIE MEGGISON
    PORTLAND, ME
    ZIP 04101
  • Facility Phone: 207 773-7964
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KATE KENNEDY
  • NPI Number: 1558456459
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 20D0864869
LAB Type Ambulatory Surgery Center
Facility Name PORTLAND ENDOSCOPY CENTER
Street 161 MARGINAL WAY ATTN LESLIE MEGGISON
City PORTLAND
State ME
ZIP 04101
Phone 207 773-7964
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Ambulatory Surgery Center
Lab Director KATE KENNEDY

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