33D0966363 CLIA NUMBER - CHAUTAUQUA MEDICAL PRACTICE PC

Laboratory Demographics

  • CLIA Code: 33D0966363
  • Facility Name: CHAUTAUQUA MEDICAL PRACTICE PC
  • Facility Address: 4936 MAIN ST
    BEMUS POINT, NY
    ZIP 14712
  • Facility Phone: 716 386-2414
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. PAUL S. HOLLEY
  • NPI Number: 1922181767
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D0966363
LAB Type Physician Office
Facility Name CHAUTAUQUA MEDICAL PRACTICE PC
Street 4936 MAIN ST
City BEMUS POINT
State NY
ZIP 14712
Phone 716 386-2414
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2020
Certificate Expiration Date 3/26/2027
Facility Type Physician Office
Lab Director DR. PAUL S. HOLLEY

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