05D0985282 CLIA NUMBER - SHAHIDA DADABHOY A PROFESSIONAL CORPORATION

Laboratory Demographics

CLIA Number: 05D0985282

Facility Name: SHAHIDA DADABHOY A PROFESSIONAL CORPORATION

Facility Address:
145 W WILLOW ST
POMONA, CA
ZIP 91768
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Facility Phone Number: 909 865-5555

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1669472163

Taxonomy: 2080A0000X - Pediatrics
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

CLIA Record

Field Name	Field Value
CLIA Number	05D0985282
LAB Type	Physician Office
Facility Name	SHAHIDA DADABHOY A PROFESSIONAL CORPORATION
Street	145 W WILLOW ST
City	POMONA
State	CA
ZIP	91768
Phone	909 865-5555
CertificateType	4
CertificateEffectiveDate	4/12/2023
CertificateExpirationDate	4/11/2025
FacilityType	Waiver

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