20D1071965 CLIA NUMBER - BETHEL AMBULANCE SERVICE

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Laboratory Demographics

CLIA Number: 20D1071965

Facility Name: BETHEL AMBULANCE SERVICE

Facility Address:
183 MAIN STREET, PO BOX 1660
BETHEL, ME
ZIP 04217
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Facility Phone Number: 207 824-2815

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1053497313

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	20D1071965
LAB Type	Ambulance
Facility Name	BETHEL AMBULANCE SERVICE
Street	183 MAIN STREET, PO BOX 1660
City	BETHEL
State	ME
ZIP	04217
Phone	207 824-2815
CertificateType	4
CertificateEffectiveDate	8/7/2023
CertificateExpirationDate	8/6/2025
FacilityType	Waiver

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