20D2249541 CLIA NUMBER - CONVENIENTMD SANFORD

Laboratory Demographics

  • CLIA Code: 20D2249541
  • Facility Name: CONVENIENTMD SANFORD
  • Facility Address: 1420 MAIN ST
    SANFORD, ME
    ZIP 04073
  • Facility Phone: 207 850-5744
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: SHAMRANG KHALSA
  • NPI Number: 1093460479
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 20D2249541
LAB Type Other - URGENT CARE
Facility Name CONVENIENTMD SANFORD
Street 1420 MAIN ST
City SANFORD
State ME
ZIP 04073
Phone 207 850-5744
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/15/2025
Certificate Expiration Date 6/14/2027
Facility Type Other - URGENT CARE
Lab Director SHAMRANG KHALSA

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