Clinical Laboratory Information
Similar CLIA Codes
|
|
CLIA Number
|
20D2312698
|
|
Clinical laboratory number
|
|
Lab Name
|
PINE TREE RECOVERY CENTER, LLC
|
|
Laboratory Name
|
|
Lab Type
|
Independent
|
|
Laboratory Type
|
|
Certificate Type
|
Waiver
|
|
Clinical laboratory certificate type
|
Contacts |
|
Phone
|
609-681-5982
|
|
Laboratory telephone number
|
|
Fax
|
N/S (NOT SPECIFIED)
|
|
Fax number of the provider.
|
Facility Location |
|
Street Address
|
1250 FOREST AVE
|
|
Primary location adress line
|
|
City
|
PORTLAND
|
|
Primary location city name
|
|
State
|
ME
|
|
Primary location state name
|
|
Zip
|
04103
|
|
Primary location postal code
|