33D0967645 CLIA NUMBER - GENERAL PHYSICIAN PC

Laboratory Demographics

  • CLIA Code: 33D0967645
  • Facility Name: GENERAL PHYSICIAN PC
  • Facility Address: 7616 TRANSIT RD
    WILLIAMSVILLE, NY
    ZIP 14221
  • Facility Phone: 716 656-4077
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. THEODORE T. COSTICH

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CLIA Record

Field Name Field Value
CLIA Number 33D0967645
LAB Type Physician Office
Facility Name GENERAL PHYSICIAN PC
Street 7616 TRANSIT RD
City WILLIAMSVILLE
State NY
ZIP 14221
Phone 716 656-4077
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 11/18/2023
Certificate Expiration Date 11/17/2025
Facility Type Physician Office
Lab Director DR. THEODORE T. COSTICH

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This page was last updated on: 6/4/2025