20D2041929 CLIA NUMBER - MAINEHEALTH PRIMARY CARE INTERNAL MEDICINE BIDDEFORD

Laboratory Demographics

  • CLIA Code: 20D2041929
  • Facility Name: MAINEHEALTH PRIMARY CARE INTERNAL MEDICINE BIDDEFORD
  • Facility Address: 9 HEALTHCARE DRIVE
    BIDDEFORD, ME
    ZIP 04005
  • Facility Phone: 207 283-7880
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ASHLEY WILLES
  • NPI Number: 1295259687
  • Taxonomy: 1223E0200X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 20D2041929
LAB Type Physician Office
Facility Name MAINEHEALTH PRIMARY CARE INTERNAL MEDICINE BIDDEFORD
Street 9 HEALTHCARE DRIVE
City BIDDEFORD
State ME
ZIP 04005
Phone 207 283-7880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2024
Certificate Expiration Date 5/31/2026
Facility Type Physician Office
Lab Director ASHLEY WILLES

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This page was last updated on: 9/29/2025