33D2275238 CLIA NUMBER - GREAT LAKES PHYSICIAN PRACTICE OB-GYN

Laboratory Demographics

  • CLIA Code: 33D2275238
  • Facility Name: GREAT LAKES PHYSICIAN PRACTICE OB-GYN
  • Facility Address: 17 SHERMAN ST
    JAMESTOWN, NY
    ZIP 14701
  • Facility Phone: 716 483-3520
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MS. BRENDA MUNELLA
  • NPI Number: 1730599176
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 33D2275238
LAB Type Physician Office
Facility Name GREAT LAKES PHYSICIAN PRACTICE OB-GYN
Street 17 SHERMAN ST
City JAMESTOWN
State NY
ZIP 14701
Phone 716 483-3520
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 1/18/2023
Certificate Expiration Date 3/26/2027
Facility Type Physician Office
Lab Director MS. BRENDA MUNELLA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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