33D0893325 CLIA NUMBER - FIVE CORNERS FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 33D0893325
  • Facility Name: FIVE CORNERS FAMILY PRACTICE
  • Facility Address: 3040 BROADWAY
    ROTTERDAM, NY
    ZIP 12306
  • Facility Phone: 518 357-2011
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DONNA TUTTLE MD
  • NPI Number: 1851353882
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D0893325
LAB Type Physician Office
Facility Name FIVE CORNERS FAMILY PRACTICE
Street 3040 BROADWAY
City ROTTERDAM
State NY
ZIP 12306
Phone 518 357-2011
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/20/2024
Certificate Expiration Date 10/19/2026
Facility Type Physician Office
Lab Director DONNA TUTTLE MD

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