20D2065370 CLIA NUMBER - FORE RIVER UROLOGY

Laboratory Demographics

  • CLIA Code: 20D2065370
  • Facility Name: FORE RIVER UROLOGY
  • Facility Address: 21 DONALD B BEAN DRIVE, SUITE 1
    SOUTH PORTLAND, ME
    ZIP 04106
  • Facility Phone: 207 518-6600
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: CLARA E. MESONERO
  • NPI Number: 1003248436
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 20D2065370
LAB Type Physician Office
Facility Name FORE RIVER UROLOGY
Street 21 DONALD B BEAN DRIVE, SUITE 1
City SOUTH PORTLAND
State ME
ZIP 04106
Phone 207 518-6600
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 6/3/2024
Certificate Expiration Date 6/2/2026
Facility Type Physician Office
Lab Director CLARA E. MESONERO

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