20D1019366 CLIA NUMBER - JANE MCNALLY DO PA

Laboratory Demographics

  • CLIA Code: 20D1019366
  • Facility Name: JANE MCNALLY DO PA
  • Facility Address: 650 BRIGHTON AVE
    PORTLAND, ME
    ZIP 04102
  • Facility Phone: 207 822-9898
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JANE D. MCNALLY DO
  • NPI Number: 1790890440
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 20D1019366
LAB Type Physician Office
Facility Name JANE MCNALLY DO PA
Street 650 BRIGHTON AVE
City PORTLAND
State ME
ZIP 04102
Phone 207 822-9898
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2023
Certificate Expiration Date 11/17/2025
Facility Type Physician Office
Lab Director JANE D. MCNALLY DO

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This page was last updated on: 6/4/2025