33D0692520 CLIA NUMBER - WEBSTER MEDICAL GROUP PC

Laboratory Demographics

  • CLIA Code: 33D0692520
  • Facility Name: WEBSTER MEDICAL GROUP PC
  • Facility Address: 45 WEBSTER COMMONS BLVD SUITE 200
    WEBSTER, NY
    ZIP 14580
  • Facility Phone: 585 872-2475
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PERIASAMY SAMIKKANNU
  • NPI Number: 1609905207
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D0692520
LAB Type Physician Office
Facility Name WEBSTER MEDICAL GROUP PC
Street 45 WEBSTER COMMONS BLVD SUITE 200
City WEBSTER
State NY
ZIP 14580
Phone 585 872-2475
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2024
Certificate Expiration Date 3/9/2026
Facility Type Physician Office
Lab Director PERIASAMY SAMIKKANNU

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