Diabetes Health Source
Director
							Julietta Fiscella, M.D.
			Expiration Date
							Phone Number
							(585) 341-7066
			UID (Facility ID - Site ID)
							F136-0000
			Site ID
							0000
			City
							Rochester
			CLIA Number
							33D2255511
			Street Address
							2400 S Clinton Ave - Bldg H Ste 135
			State
							NY
			Zip Code
							14618
			County
							Monroe
			Country
							United States
			Primary Contact
							Matthew Stewart
			Contact Phone Number
							(585) 341-8458
			Certificate Type
							WAIVER
			Tests
				Glucose
							Glycosylated Hemoglobin
					Facility ID
							F136