20D2251436 CLIA NUMBER - COLD RIVER HEALTH, LLC

Laboratory Demographics

CLIA Number: 20D2251436

Facility Name: COLD RIVER HEALTH, LLC

Facility Address:
567 MAIN ST
LOVELL, ME
ZIP 04051
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Facility Phone Number: 207 200-4329

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1871256941

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	20D2251436
LAB Type	Physician Office
Facility Name	COLD RIVER HEALTH, LLC
Street	567 MAIN ST
City	LOVELL
State	ME
ZIP	04051
Phone	207 200-4329
CertificateType	3
CertificateEffectiveDate	2/3/2024
CertificateExpirationDate	2/2/2026
FacilityType	PPMP

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This page was last updated on: 4/23/2024