20D2218968 CLIA NUMBER - BISHOP MEDICAL GROUP LLC

Laboratory Demographics

  • CLIA Code: 20D2218968
  • Facility Name: BISHOP MEDICAL GROUP LLC
  • Facility Address: 100 GANNETT DRIVE STE B
    PORTLAND, ME
    ZIP 04106
  • Facility Phone: 207 910-6580
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: TAMER WASSEF
  • NPI Number: 1487256186
  • Taxonomy: 2084A0401X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 20D2218968
LAB Type Ancillary Testing Site in Health Care Center
Facility Name BISHOP MEDICAL GROUP LLC
Street 100 GANNETT DRIVE STE B
City PORTLAND
State ME
ZIP 04106
Phone 207 910-6580
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Ancillary Testing Site in Health Care Center
Lab Director TAMER WASSEF

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