NPIMap

Organization Active NPI

CWCL - Coastal Womens Clinical Lab

  • Clinical Medical Laboratory
  • Scarborough, ME
National Provider Identifier
1780737270
Registry record updated Sep 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
20D0088760 Issued in ME
Legal business name
CWCL - COASTAL WOMENS CLINICAL LAB
Practice address
71 US Route One
Suite a, Elevation Center
Scarborough, ME 04074-9375
Phone
(207) 885-8400
Fax
(207) 885-8499
NPI assigned
Jan 19, 2007
Reactivated
Dec 17, 2008
Organization subpart
Yes
Parent organization
COASTAL WOMENS HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Kelly A Gagnon
Title
Operations Director
Phone
(207) 885-8445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 20D0088760 ME Primary

Addresses

Primary practice location

71 US Route One
Suite a, Elevation Center
Scarborough, ME 04074-9375

Mailing address

71 US Route One
Suite a, Elevation Center
Scarborough, ME 04074-9375
Phone (207) 885-8400

Other identifiers 2

IdentifierTypeStateIssuer
015617OtherMEANTHEM STAR NUMBER
800794OtherMEHARVARD PAYEE NUMBER

Other names 1

  • Coastal Womens Healthcare Med Lab Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D0686727Coastal Womens Healthcare71 US Route One, Suite a, Scarborough, ME 04074Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
CWCL - Coastal Womens Clinical Lab2 organizations share this tax ID, including this one
Part of
CWCL - Coastal Womens Clinical Lab

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.758

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285200000000",
    "number": "1780737270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 US ROUTE ONE",
            "address_2": "SUITE A, ELEVATION CENTER",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749375",
            "telephone_number": "207-885-8400",
            "fax_number": "207-885-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 US ROUTE ONE",
            "address_2": "SUITE A, ELEVATION CENTER",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749375",
            "telephone_number": "207-885-8400",
            "fax_number": "207-885-8499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CWCL - COASTAL WOMENS CLINICAL LAB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COASTAL WOMENS HEALTHCARE",
        "enumeration_date": "2007-01-19",
        "last_updated": "2010-09-23",
        "deactivation_date": "2008-06-25",
        "reactivation_date": "2008-12-17",
        "status": "A",
        "authorized_official_last_name": "GAGNON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "207-885-8445",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "ME",
            "license": "20D0088760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM STAR NUMBER",
            "identifier": "015617",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PAYEE NUMBER",
            "identifier": "800794",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Womens Healthcare Med Lab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Scarborough, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.