20D2196961 CLIA NUMBER - FRANKLIN COUNTY JAIL- MEDICAL DEPARTMENT MED PRO ASSOCIATES

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Laboratory Demographics

CLIA Number: 20D2196961

Facility Name: FRANKLIN COUNTY JAIL- MEDICAL DEPARTMENT MED PRO ASSOCIATES

Facility Address:
121 COUNTY WAY
FARMINGTON, ME
ZIP 04938
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Facility Phone Number: 207 860-4025

Facility Type: Prison

Certificate Type: Waiver

NPI Number: 1811451081

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	20D2196961
LAB Type	Prison
Facility Name	FRANKLIN COUNTY JAIL- MEDICAL DEPARTMENT MED PRO ASSOCIATES
Street	121 COUNTY WAY
City	FARMINGTON
State	ME
ZIP	04938
Phone	207 860-4025
CertificateType	4
CertificateEffectiveDate	10/21/2022
CertificateExpirationDate	10/20/2024
FacilityType	Waiver

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