20D2155397 CLIA NUMBER - CONVENIENTMD URGENT CARE

Laboratory Demographics

  • CLIA Code: 20D2155397
  • Facility Name: CONVENIENTMD URGENT CARE
  • Facility Address: 543 BROADWAY STREET
    BANGOR, ME
    ZIP 04401
  • Facility Phone: 207 922-1300
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: SHAMRANG KHALSA
  • NPI Number: 1992281422
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 20D2155397
LAB Type Other - URGENT CARE
Facility Name CONVENIENTMD URGENT CARE
Street 543 BROADWAY STREET
City BANGOR
State ME
ZIP 04401
Phone 207 922-1300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2025
Certificate Expiration Date 1/16/2027
Facility Type Other - URGENT CARE
Lab Director SHAMRANG KHALSA

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