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General NPI Number Information
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NPI Number | 1407985302
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Entity Type | Organization
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Legal Business Name | STATE OF MAINE HEALTH AND ENVIRONMENTAL TESSTING LABORATORY
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | STATION 12 221 STATE STREET
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City | AUGUSTA
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State | ME
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Zip | 04333-0001
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Country | US
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Telephone | 207-287-2703
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Fax |
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Provider Business Mailing Address
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Address Line | STATION 12 221 STATE STREET
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City | AUGUSTA
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State | ME
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Zip | 04333-0001
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Country | US
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Telephone | 207-287-2703
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Fax |
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Authorized Official
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Title or Position | SENIOR SCIENTIST CLIA LAB DIRECTOR
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Name | DR. KENNETH G. POTE
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Credential | PH.D.
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Telephone | 207-287-2703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | ME
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