33D1019478 CLIA NUMBER - WNY PRIMARY CARE MEDICINE

Laboratory Demographics

  • CLIA Code: 33D1019478
  • Facility Name: WNY PRIMARY CARE MEDICINE
  • Facility Address: 277 DIVISION STREET
    NORTH TONAWANDA, NY
    ZIP 14120
  • Facility Phone: 716 690-1159
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. GHOUS A. YASIN
  • NPI Number: 1124075908
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D1019478
LAB Type Physician Office
Facility Name WNY PRIMARY CARE MEDICINE
Street 277 DIVISION STREET
City NORTH TONAWANDA
State NY
ZIP 14120
Phone 716 690-1159
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2023
Certificate Expiration Date 11/18/2025
Facility Type Physician Office
Lab Director DR. GHOUS A. YASIN

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