20D2201194 CLIA NUMBER - MILESTONE RECOVERY

Laboratory Demographics

  • CLIA Code: 20D2201194
  • Facility Name: MILESTONE RECOVERY
  • Facility Address: 65 INDIA ST
    PORTLAND, ME
    ZIP 04101
  • Facility Phone: 207 775-4790
  • Facility Type: Other - 24HR DETOX FREE STAND. R
  • Facility Type: Waiver
  • Lab Director: CHRISTINE M. COOK
  • NPI Number: 1063548436
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 20D2201194
LAB Type Other - 24HR DETOX FREE STAND. R
Facility Name MILESTONE RECOVERY
Street 65 INDIA ST
City PORTLAND
State ME
ZIP 04101
Phone 207 775-4790
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2024
Certificate Expiration Date 11/18/2026
Facility Type Other - 24HR DETOX FREE STAND. R
Lab Director CHRISTINE M. COOK

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