20D2322037 CLIA NUMBER - CONVENIENTMD PRIMARY CARE - BANGOR

Laboratory Demographics

  • CLIA Code: 20D2322037
  • Facility Name: CONVENIENTMD PRIMARY CARE - BANGOR
  • Facility Address: 689 BROADWAY
    BANGOR, ME
    ZIP 04401
  • Facility Phone: 207 744-8424
  • Facility Type: Other - PRIMARY CARE
  • Facility Type: Waiver
  • Lab Director: KARIN M. DOEHNE
  • NPI Number: 1881401552
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 20D2322037
LAB Type Other - PRIMARY CARE
Facility Name CONVENIENTMD PRIMARY CARE - BANGOR
Street 689 BROADWAY
City BANGOR
State ME
ZIP 04401
Phone 207 744-8424
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2025
Certificate Expiration Date 4/14/2027
Facility Type Other - PRIMARY CARE
Lab Director KARIN M. DOEHNE

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