20D2322815 CLIA NUMBER - MAINEHEALTH PRIMARY CARE FAMILY MEDICINE BELFAST

Laboratory Demographics

  • CLIA Code: 20D2322815
  • Facility Name: MAINEHEALTH PRIMARY CARE FAMILY MEDICINE BELFAST
  • Facility Address: 119 NORTHPORT AVE 2ND FLOOR
    BELFAST, ME
    ZIP 04915
  • Facility Phone: 207 301-8480
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JENNY DAVIS
  • NPI Number: 1851869648
  • Taxonomy: 261QD0000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 20D2322815
LAB Type Physician Office
Facility Name MAINEHEALTH PRIMARY CARE FAMILY MEDICINE BELFAST
Street 119 NORTHPORT AVE 2ND FLOOR
City BELFAST
State ME
ZIP 04915
Phone 207 301-8480
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2025
Certificate Expiration Date 4/27/2027
Facility Type Physician Office
Lab Director JENNY DAVIS

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