20D2041929 CLIA NUMBER - MEHEALTH SMHC PHYSICIAN PRACTICES

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Laboratory Demographics

CLIA Number: 20D2041929

Facility Name: MEHEALTH SMHC PHYSICIAN PRACTICES

Facility Address:
9 HEALTHCARE DRIVE
BIDDEFORD, ME
ZIP 04005
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Facility Phone Number: 207 283-7880

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1295259687

Taxonomy: 1223E0200X - Dentist
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

CLIA Record

Field Name	Field Value
CLIA Number	20D2041929
LAB Type	Physician Office
Facility Name	MEHEALTH SMHC PHYSICIAN PRACTICES
Street	9 HEALTHCARE DRIVE
City	BIDDEFORD
State	ME
ZIP	04005
Phone	207 283-7880
CertificateType	4
CertificateEffectiveDate	6/1/2022
CertificateExpirationDate	5/31/2024
FacilityType	Waiver

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