20D0911001 CLIA NUMBER - MAINEHEALTH PRIMARY CARE FAMILY MEDICINE STOCKTON SPRING

Laboratory Demographics

  • CLIA Code: 20D0911001
  • Facility Name: MAINEHEALTH PRIMARY CARE FAMILY MEDICINE STOCKTON SPRING
  • Facility Address: 11 CAPE JELLISON ROAD
    STOCKTON SPRINGS, ME
    ZIP 04981
  • Facility Phone: 207 301-8480
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DAPHNE LANG
  • NPI Number: 1295800118
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 20D0911001
LAB Type Rural Health Clinic
Facility Name MAINEHEALTH PRIMARY CARE FAMILY MEDICINE STOCKTON SPRING
Street 11 CAPE JELLISON ROAD
City STOCKTON SPRINGS
State ME
ZIP 04981
Phone 207 301-8480
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/13/2024
Certificate Expiration Date 10/12/2026
Facility Type Rural Health Clinic
Lab Director DAPHNE LANG

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