CLIA lab
CLIA 33D2002112: Great Lakes Physician PC
Derby, NY. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 33D2002112 belongs to Great Lakes Physician PC in Derby, NY.
Certificate of Waiver, effective January 7, 2026, expires January 6, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- January 7, 2026
- Certificate expiration
- January 6, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 7, 2010
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 33D2002112
- Lab name
- Great Lakes Physician PC
- Address
- Derby Professional Park, 7060 Erie Road Suite 400, Derby, NY 14047
- Phone
- (716) 677-2273
- Fax
- (716) 677-2256
Annual test volume the lab reported
- Waived tests
- 783
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Highland Hose Vol Fire Co IncCertificate of Waiver, Ambulance33D2326039
- John Mulawka DO PCCertificate of Waiver, Physician office33D1049131
- Lakeshore Family MedicineCertificate of Waiver, Physician office33D0928737
- Wny Medical, PCCertificate of Waiver, Physician office33D0901416
Related
Questions
What is the CLIA number for Great Lakes Physician PC in Derby?
33D2002112, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Great Lakes Physician PC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 33D2002112 expire?
The CMS file lists January 6, 2028 as the certificate expiration date; the certificate took effect January 7, 2026.