CLIA lab
CLIA 33D2177268: Brockport Vine Medical PC
Brockport, NY. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 33D2177268 belongs to Brockport Vine Medical PC in Brockport, NY.
Certificate of Waiver, effective January 8, 2026, expires January 7, 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 8, 2026
- Certificate expiration
- January 7, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 8, 2020
- 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
- 33D2177268
- Lab name
- Brockport Vine Medical PC
- Address
- 122 West Avenue - Ste 6B, Brockport, NY 14420
- Phone
- (585) 391-3040
- Fax
- (585) 617-4219
Annual test volume the lab reported
- Waived tests
- 100
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Brockport, NY
- Brockport Internal Medicine PCCertificate of Waiver, Physician office33D0171600
- Brockport Medical Care, PLLCCertificate of Waiver, Physician office33D2060532
- Brockport Optometry, PCCertificate of Waiver, Physician office33D2113966
- CVS Pharmacy No 05123Certificate of Waiver, Pharmacy33D2187453
- Center for UrologyCertificate for Provider-Performed Microscopy Procedures, Physician office33D0173791
- Elderwood of Lakeside at BrockportCertificate of Waiver, Skilled nursing or nursing facility33D0654836
- Evergreen PlaceCertificate of Waiver, Assisted living facility33D2151479
- Hany G Nissiem Family Medicine PLLCCertificate of Waiver, Physician office33D1039535
- Oak Orchard Community Health Center IncCertificate of Waiver, Community clinic33D0171633
- Suny Brockport Student Health CenterCertificate for Provider-Performed Microscopy Procedures, School or student health service33D0677045
Related
Questions
What is the CLIA number for Brockport Vine Medical PC in Brockport?
33D2177268, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Brockport Vine Medical PC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 33D2177268 expire?
The CMS file lists January 7, 2028 as the certificate expiration date; the certificate took effect January 8, 2026.