20D2092879 CLIA NUMBER - MAINE MOLECULAR IMAGING

Laboratory Demographics

  • CLIA Code: 20D2092879
  • Facility Name: MAINE MOLECULAR IMAGING
  • Facility Address: 2 ADMIRAL FITCH AVE, STE A
    BRUNSWICK, ME
    ZIP 04011
  • Facility Phone: 207 542-2308
  • Facility Type: Other - MOBILE PET/CT UNIT
  • Facility Type: Waiver
  • Lab Director: MICHAEL QUINN
  • NPI Number: 1285682591
  • Taxonomy: 293D00000X - Physiological Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 20D2092879
LAB Type Other - MOBILE PET/CT UNIT
Facility Name MAINE MOLECULAR IMAGING
Street 2 ADMIRAL FITCH AVE, STE A
City BRUNSWICK
State ME
ZIP 04011
Phone 207 542-2308
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/16/2025
Certificate Expiration Date 3/15/2027
Facility Type Other - MOBILE PET/CT UNIT
Lab Director MICHAEL QUINN

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