20D2245747 CLIA NUMBER - FALLBROOK WOODS RESIDENTIAL CARE FACILITY

Laboratory Demographics

  • CLIA Code: 20D2245747
  • Facility Name: FALLBROOK WOODS RESIDENTIAL CARE FACILITY
  • Facility Address: 60 MERRYMEETING DR
    PORTLAND, ME
    ZIP 04103
  • Facility Phone: 207 878-0788
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DIANE E. BYNION
  • NPI Number: 1477881951
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 20D2245747
LAB Type Assisted Living Facility
Facility Name FALLBROOK WOODS RESIDENTIAL CARE FACILITY
Street 60 MERRYMEETING DR
City PORTLAND
State ME
ZIP 04103
Phone 207 878-0788
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2023
Certificate Expiration Date 12/15/2025
Facility Type Assisted Living Facility
Lab Director DIANE E. BYNION

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