20D2137806 CLIA NUMBER - CONVENIENTMD PORTLAND

Laboratory Demographics

  • CLIA Code: 20D2137806
  • Facility Name: CONVENIENTMD PORTLAND
  • Facility Address: 191 MARGINAL WAY
    PORTLAND, ME
    ZIP 04101
  • Facility Phone: 207 517-3838
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: SHAMRANG KHALSA
  • NPI Number: 1073038618
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 20D2137806
LAB Type Other - URGENT CARE
Facility Name CONVENIENTMD PORTLAND
Street 191 MARGINAL WAY
City PORTLAND
State ME
ZIP 04101
Phone 207 517-3838
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2024
Certificate Expiration Date 12/14/2026
Facility Type Other - URGENT CARE
Lab Director SHAMRANG KHALSA

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