20D2306044 CLIA NUMBER - BRISTOL HOSPICE - BANGOR, LLC

Laboratory Demographics

  • CLIA Code: 20D2306044
  • Facility Name: BRISTOL HOSPICE - BANGOR, LLC
  • Facility Address: 824 STILLWATER AVE STE B
    BANGOR, ME
    ZIP 04401
  • Facility Phone: 207 605-9620
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: ERICA LILLY
  • NPI Number: 1336916469
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 20D2306044
LAB Type Hospice
Facility Name BRISTOL HOSPICE - BANGOR, LLC
Street 824 STILLWATER AVE STE B
City BANGOR
State ME
ZIP 04401
Phone 207 605-9620
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2024
Certificate Expiration Date 6/10/2026
Facility Type Hospice
Lab Director ERICA LILLY

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This page was last updated on: 6/4/2025