33D2281947 CLIA NUMBER - GENERAL PHYSICIAN, PC

Laboratory Demographics

  • CLIA Code: 33D2281947
  • Facility Name: GENERAL PHYSICIAN, PC
  • Facility Address: 415 TREMONT STREET SUITE 4
    NORTH TONAWANDA, NY
    ZIP 14120
  • Facility Phone: 716 248-1412
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RICHARD CHARLES
  • NPI Number: 1982099396
  • Taxonomy: 207RI0011X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D2281947
LAB Type Physician Office
Facility Name GENERAL PHYSICIAN, PC
Street 415 TREMONT STREET SUITE 4
City NORTH TONAWANDA
State NY
ZIP 14120
Phone 716 248-1412
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2025
Certificate Expiration Date 5/14/2027
Facility Type Physician Office
Lab Director DR. RICHARD CHARLES

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