20D0969392 CLIA NUMBER - MID COAST MEDICAL GROUP

Laboratory Demographics

CLIA Number: 20D0969392

Facility Name: MID COAST MEDICAL GROUP

Facility Address:
121 MEDICAL CENTER DR, G450
BRUNSWICK, ME
ZIP 04011
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Facility Phone Number: 207 373-6860

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1396726501

Taxonomy: 314000000X - Skilled Nursing Facility
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

CLIA Record

Field Name	Field Value
CLIA Number	20D0969392
LAB Type	Physician Office
Facility Name	MID COAST MEDICAL GROUP
Street	121 MEDICAL CENTER DR, G450
City	BRUNSWICK
State	ME
ZIP	04011
Phone	207 373-6860
CertificateType	3
CertificateEffectiveDate	1/13/2024
CertificateExpirationDate	1/12/2026
FacilityType	PPMP

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