20D2248878 CLIA NUMBER - MY VIRTUAL MEDICAL VISIT

Laboratory Demographics

  • CLIA Code: 20D2248878
  • Facility Name: MY VIRTUAL MEDICAL VISIT
  • Facility Address: 1723 HAMMOND ST SUITE #2
    HERMON, ME
    ZIP 04401
  • Facility Phone: 207 252-3651
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LORRAINE M. MORIN
  • NPI Number: 1104570449
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 20D2248878
LAB Type Physician Office
Facility Name MY VIRTUAL MEDICAL VISIT
Street 1723 HAMMOND ST SUITE #2
City HERMON
State ME
ZIP 04401
Phone 207 252-3651
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2024
Certificate Expiration Date 1/17/2026
Facility Type Physician Office
Lab Director LORRAINE M. MORIN

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