20D1077200 CLIA NUMBER - CAPE ELIZABETH RESCUE

Laboratory Demographics

CLIA Number: 20D1077200

Facility Name: CAPE ELIZABETH RESCUE

Facility Address:
2 JORDAN WAY
CAPE ELIZABETH, ME
ZIP 04107
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Facility Phone Number: 207 767-7417

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1922052745

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	20D1077200
LAB Type	Ambulance
Facility Name	CAPE ELIZABETH RESCUE
Street	2 JORDAN WAY
City	CAPE ELIZABETH
State	ME
ZIP	04107
Phone	207 767-7417
CertificateType	4
CertificateEffectiveDate	12/4/2023
CertificateExpirationDate	12/3/2025
FacilityType	Waiver

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