20D2178389 CLIA NUMBER - NORTHERN LIGHT ENDOCRINOLOGY AND DIABETES CARE

Laboratory Demographics

  • CLIA Code: 20D2178389
  • Facility Name: NORTHERN LIGHT ENDOCRINOLOGY AND DIABETES CARE
  • Facility Address: 246 KENNEDY MEMORIAL DRIVE FIRST FLOOR
    WATERVILLE, ME
    ZIP 04901
  • Facility Phone: 207 861-7150
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DOMINIQUE UVA
  • NPI Number: 1336238039
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 20D2178389
LAB Type Physician Office
Facility Name NORTHERN LIGHT ENDOCRINOLOGY AND DIABETES CARE
Street 246 KENNEDY MEMORIAL DRIVE FIRST FLOOR
City WATERVILLE
State ME
ZIP 04901
Phone 207 861-7150
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2024
Certificate Expiration Date 2/2/2026
Facility Type Physician Office
Lab Director DOMINIQUE UVA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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