20D2192822 CLIA NUMBER - AURORA HEALTHCARE

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Laboratory Demographics

CLIA Number: 20D2192822

Facility Name: AURORA HEALTHCARE

Facility Address:
121 MAIN ST
FAIRFIELD, ME
ZIP 04937
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Facility Phone Number: 207 859-3165

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1245845361

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	20D2192822
LAB Type	Practitioner Other
Facility Name	AURORA HEALTHCARE
Street	121 MAIN ST
City	FAIRFIELD
State	ME
ZIP	04937
Phone	207 859-3165
CertificateType	4
CertificateEffectiveDate	9/15/2022
CertificateExpirationDate	9/14/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024