20D2130581 CLIA NUMBER - DISCOVERY HOUSE - SOUTH PORTLAND

Laboratory Demographics

  • CLIA Code: 20D2130581
  • Facility Name: DISCOVERY HOUSE - SOUTH PORTLAND
  • Facility Address: 400 WESTERN AVE
    SOUTH PORTLAND, ME
    ZIP 04106
  • Facility Phone: 207 774-7111
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: ALEXANDER MILLIKEN
  • NPI Number: 1447000880
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 20D2130581
LAB Type Comp. Outpatient Rehab Facility
Facility Name DISCOVERY HOUSE - SOUTH PORTLAND
Street 400 WESTERN AVE
City SOUTH PORTLAND
State ME
ZIP 04106
Phone 207 774-7111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director ALEXANDER MILLIKEN

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