20D2147810 CLIA NUMBER - PREBLE STREET LEARNING COLLABORATIVE

Laboratory Demographics

  • CLIA Code: 20D2147810
  • Facility Name: PREBLE STREET LEARNING COLLABORATIVE
  • Facility Address: 20 PORTLAND ST
    PORTLAND, ME
    ZIP 04101
  • Facility Phone: 207 661-4701
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: EMILY I. ZAROOKIAN
  • NPI Number: 1407206287
  • Taxonomy: 251B00000X - Case Management

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CLIA Record

Field Name Field Value
CLIA Number 20D2147810
LAB Type Community Clinic
Facility Name PREBLE STREET LEARNING COLLABORATIVE
Street 20 PORTLAND ST
City PORTLAND
State ME
ZIP 04101
Phone 207 661-4701
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2024
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director EMILY I. ZAROOKIAN

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