33D2208519 CLIA NUMBER - HERITAGE CHRISTIAN SERVICES INC

Laboratory Demographics

CLIA Code: 33D2208519
Facility Name: HERITAGE CHRISTIAN SERVICES INC
Facility Address: 275 KENNETH DRIVE SUITE 100
ROCHESTER, NY
ZIP 14623
Facility Phone: 585 340-2000
Facility Type: Other - IRA FOR DEV DISABLED
Facility Type: Waiver
Lab Director: DR. JUSTIN WACLAWEK
NPI Number: 1700077443
Taxonomy: 320600000X - Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	33D2208519
LAB Type	Other - IRA FOR DEV DISABLED
Facility Name	HERITAGE CHRISTIAN SERVICES INC
Street	275 KENNETH DRIVE SUITE 100
City	ROCHESTER
State	NY
ZIP	14623
Phone	585 340-2000
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	1/7/2021
Certificate Expiration Date	3/26/2027
Facility Type	Other - IRA FOR DEV DISABLED
Lab Director	DR. JUSTIN WACLAWEK

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