20D2329936 CLIA NUMBER - PINE TREE URGENT CARE LLC

Laboratory Demographics

  • CLIA Code: 20D2329936
  • Facility Name: PINE TREE URGENT CARE LLC
  • Facility Address: 557 HAMMOND STREET
    BANGOR, ME
    ZIP 04401
  • Facility Phone: 207 239-9757
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: DAVID P. WADE
  • NPI Number: 1679450969
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 20D2329936
LAB Type Independent
Facility Name PINE TREE URGENT CARE LLC
Street 557 HAMMOND STREET
City BANGOR
State ME
ZIP 04401
Phone 207 239-9757
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2025
Certificate Expiration Date 9/8/2027
Facility Type Independent
Lab Director DAVID P. WADE

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