20D2203514 CLIA NUMBER - HALLDALE MANOR

Laboratory Demographics

  • CLIA Code: 20D2203514
  • Facility Name: HALLDALE MANOR
  • Facility Address: 647 MAINE AVE
    FARMINGDALE, ME
    ZIP 04344
  • Facility Phone: 207 622-7082
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DESTINY J. BONNELL
  • NPI Number: 1780885806
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 20D2203514
LAB Type Assisted Living Facility
Facility Name HALLDALE MANOR
Street 647 MAINE AVE
City FARMINGDALE
State ME
ZIP 04344
Phone 207 622-7082
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/4/2024
Certificate Expiration Date 12/3/2026
Facility Type Assisted Living Facility
Lab Director DESTINY J. BONNELL

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