20D1044192 CLIA NUMBER - CONCENTRA URGENT CARE - AUGUSTA

Laboratory Demographics

CLIA Number: 20D1044192

Facility Name: CONCENTRA URGENT CARE - AUGUSTA

Facility Address:
219 CAPITOL STREET SUITE 2
AUGUSTA, ME
ZIP 04330
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Facility Phone Number: 207 629-5005

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1457503997

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	20D1044192
LAB Type	Physician Office
Facility Name	CONCENTRA URGENT CARE - AUGUSTA
Street	219 CAPITOL STREET SUITE 2
City	AUGUSTA
State	ME
ZIP	04330
Phone	207 629-5005
CertificateType	3
CertificateEffectiveDate	12/5/2023
CertificateExpirationDate	12/4/2025
FacilityType	PPMP

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