05D0552217 CLIA NUMBER - SHAHEEN IQBAL MD

Laboratory Demographics

CLIA Number: 05D0552217

Facility Name: SHAHEEN IQBAL MD

Facility Address:
609 W BEVERLY BLVD
MONTEBELLO, CA
ZIP 90640
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Facility Phone Number: 323 728-6945

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1023384864

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D0552217
LAB Type	Physician Office
Facility Name	SHAHEEN IQBAL MD
Street	609 W BEVERLY BLVD
City	MONTEBELLO
State	CA
ZIP	90640
Phone	323 728-6945
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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