20D0963153 CLIA NUMBER - ELIZABETH LEVINSON CENTER

Laboratory Demographics

  • CLIA Code: 20D0963153
  • Facility Name: ELIZABETH LEVINSON CENTER
  • Facility Address: 159 HOGAN RD
    BANGOR, ME
    ZIP 04401
  • Facility Phone: 207 992-0600
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: ANDREW CASSIDY
  • NPI Number: 1437639150
  • Taxonomy: 183700000X - Pharmacy Technician

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CLIA Record

Field Name Field Value
CLIA Number 20D0963153
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name ELIZABETH LEVINSON CENTER
Street 159 HOGAN RD
City BANGOR
State ME
ZIP 04401
Phone 207 992-0600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2025
Certificate Expiration Date 7/22/2027
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director ANDREW CASSIDY

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