20D2292206 CLIA NUMBER - AMISTAD

Laboratory Demographics

  • CLIA Code: 20D2292206
  • Facility Name: AMISTAD
  • Facility Address: 103 INDIA ST
    PORTLAND, ME
    ZIP 04101
  • Facility Phone: 207 272-0429
  • Facility Type: Other - HARM REDUCTION DROP IN
  • Facility Type: Waiver
  • Lab Director: BRIAN M. TOWNSEND
  • NPI Number: 1982327805
  • Taxonomy: 101YM0800X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 20D2292206
LAB Type Other - HARM REDUCTION DROP IN
Facility Name AMISTAD
Street 103 INDIA ST
City PORTLAND
State ME
ZIP 04101
Phone 207 272-0429
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2023
Certificate Expiration Date 10/22/2025
Facility Type Other - HARM REDUCTION DROP IN
Lab Director BRIAN M. TOWNSEND

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