33D0955034 CLIA NUMBER - PEDIATRIC HEALTHCARE

Laboratory Demographics

  • CLIA Code: 33D0955034
  • Facility Name: PEDIATRIC HEALTHCARE
  • Facility Address: 4039 RTE 219 - SUITE 103
    SALAMANCA, NY
    ZIP 14779
  • Facility Phone: 716 945-0368
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: SRINIVAS P. THANDLA MD
  • NPI Number: 1679795025
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 33D0955034
LAB Type Ancillary Testing Site in Health Care Center
Facility Name PEDIATRIC HEALTHCARE
Street 4039 RTE 219 - SUITE 103
City SALAMANCA
State NY
ZIP 14779
Phone 716 945-0368
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2025
Certificate Expiration Date 10/2/2027
Facility Type Ancillary Testing Site in Health Care Center
Lab Director SRINIVAS P. THANDLA MD

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