33D2118833 CLIA NUMBER - MARCELLUS MEDICAL GROUP PLLC

Laboratory Demographics

  • CLIA Code: 33D2118833
  • Facility Name: MARCELLUS MEDICAL GROUP PLLC
  • Facility Address: 1/2 ORANGE STREET
    MARCELLUS, NY
    ZIP 13108
  • Facility Phone: 315 673-1529
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. KHATUNA N. STEPKOVITCH
  • NPI Number: 1437780335
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D2118833
LAB Type Physician Office
Facility Name MARCELLUS MEDICAL GROUP PLLC
Street 1/2 ORANGE STREET
City MARCELLUS
State NY
ZIP 13108
Phone 315 673-1529
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2024
Certificate Expiration Date 8/3/2026
Facility Type Physician Office
Lab Director DR. KHATUNA N. STEPKOVITCH

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