20D2234852 CLIA NUMBER - MAGNOLIA ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 20D2234852
  • Facility Name: MAGNOLIA ASSISTED LIVING
  • Facility Address: 57 MAIN ST
    BUCKSPORT, ME
    ZIP 04416
  • Facility Phone: 207 702-0144
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ED SEDACCA
  • NPI Number: 1376356311
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 20D2234852
LAB Type Assisted Living Facility
Facility Name MAGNOLIA ASSISTED LIVING
Street 57 MAIN ST
City BUCKSPORT
State ME
ZIP 04416
Phone 207 702-0144
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2023
Certificate Expiration Date 10/23/2025
Facility Type Assisted Living Facility
Lab Director ED SEDACCA

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