02D1073822 CLIA NUMBER - KATY SHERIDAN, MD, PC

Laboratory Demographics

CLIA Number: 02D1073822

Facility Name: KATY SHERIDAN, MD, PC

Facility Address:
154 W MARYDALE AVE
SOLDOTNA, AK
ZIP 99669
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Facility Phone Number: 907 260-3121

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1518983246

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	02D1073822
LAB Type	Physician Office
Facility Name	KATY SHERIDAN, MD, PC
Street	154 W MARYDALE AVE
City	SOLDOTNA
State	AK
ZIP	99669
Phone	907 260-3121
CertificateType	4
CertificateEffectiveDate	9/17/2023
CertificateExpirationDate	9/16/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024