20D2312182 CLIA NUMBER - SOUTHERN MAINE RECORVERY, LLC

Laboratory Demographics

  • CLIA Code: 20D2312182
  • Facility Name: SOUTHERN MAINE RECORVERY, LLC
  • Facility Address: 271 CUMBERLAND ST
    WESTBROOK, ME
    ZIP 04092
  • Facility Phone: 609 681-5982
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: GABRIELLE KOBACKER
  • NPI Number: 1144037649
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 20D2312182
LAB Type Independent
Facility Name SOUTHERN MAINE RECORVERY, LLC
Street 271 CUMBERLAND ST
City WESTBROOK
State ME
ZIP 04092
Phone 609 681-5982
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/7/2024
Certificate Expiration Date 10/6/2026
Facility Type Independent
Lab Director GABRIELLE KOBACKER

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