33D1081503 CLIA NUMBER - EDITH GRANNUM MD PC INTEGRATED CARE3

Laboratory Demographics

  • CLIA Code: 33D1081503
  • Facility Name: EDITH GRANNUM MD PC INTEGRATED CARE3
  • Facility Address: 2220 CLINTON AVENUE SOUTH
    ROCHESTER, NY
    ZIP 14618
  • Facility Phone: 585 461-6000
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. EDITH G. GRANNUM
  • NPI Number: 1821060237
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D1081503
LAB Type Physician Office
Facility Name EDITH GRANNUM MD PC INTEGRATED CARE3
Street 2220 CLINTON AVENUE SOUTH
City ROCHESTER
State NY
ZIP 14618
Phone 585 461-6000
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 3/19/2024
Certificate Expiration Date 3/18/2026
Facility Type Physician Office
Lab Director DR. EDITH G. GRANNUM

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