20D0928589 CLIA NUMBER - NORTHERN LIGHT CHARLES A DEAN HOSPITAL

Laboratory Demographics

CLIA Number: 20D0928589

Facility Name: NORTHERN LIGHT CHARLES A DEAN HOSPITAL

Facility Address:
364 PRITHAM AVE
GREENVILLE, ME
ZIP 04441
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Facility Phone Number: 207 695-5229

Facility Type: Hospital

Certificate Type: Certificate of Compliance

NPI Number: 1265441323

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	20D0928589
LAB Type	Hospital
Facility Name	NORTHERN LIGHT CHARLES A DEAN HOSPITAL
Street	364 PRITHAM AVE
City	GREENVILLE
State	ME
ZIP	04441
Phone	207 695-5229
CertificateType	2
CertificateEffectiveDate	8/1/2023
CertificateExpirationDate	7/31/2025
FacilityType	Compliance

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