20D2200650 CLIA NUMBER - GROUP MAIN STREAM,INC

Laboratory Demographics

CLIA Code: 20D2200650
Facility Name: GROUP MAIN STREAM,INC
Facility Address: 15 SAUNDERS WAY SUITE 500-G
WESTBROOK, ME
ZIP 04092
Facility Phone: 207 523-5171
Facility Type: Assisted Living Facility
Facility Type: Waiver
Lab Director: MAYBERRY ANN-MARIE
NPI Number: 1174769822
Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	20D2200650
LAB Type	Assisted Living Facility
Facility Name	GROUP MAIN STREAM,INC
Street	15 SAUNDERS WAY SUITE 500-G
City	WESTBROOK
State	ME
ZIP	04092
Phone	207 523-5171
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	11/17/2024
Certificate Expiration Date	11/16/2026
Facility Type	Assisted Living Facility
Lab Director	MAYBERRY ANN-MARIE

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