20D2106859 CLIA NUMBER - BANGOR EYE SURGERY

Laboratory Demographics

  • CLIA Code: 20D2106859
  • Facility Name: BANGOR EYE SURGERY
  • Facility Address: 900A HAMMOND STREET
    BANGOR, ME
    ZIP 04401
  • Facility Phone: 207 947-6743
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: CYNTHIA A. SELF
  • NPI Number: 1215309653
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 20D2106859
LAB Type Ambulatory Surgery Center
Facility Name BANGOR EYE SURGERY
Street 900A HAMMOND STREET
City BANGOR
State ME
ZIP 04401
Phone 207 947-6743
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2023
Certificate Expiration Date 12/29/2025
Facility Type Ambulatory Surgery Center
Lab Director CYNTHIA A. SELF

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