05D1018957 CLIA NUMBER - SHAHID SIDDIQUI MD

Laboratory Demographics

CLIA Number: 05D1018957

Facility Name: SHAHID SIDDIQUI MD

Facility Address:
200 JOSE FIGUERES AVE STE 365
SAN JOSE, CA
ZIP 95116
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Facility Phone Number: 408 926-8100

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1922005636

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	05D1018957
LAB Type	Physician Office
Facility Name	SHAHID SIDDIQUI MD
Street	200 JOSE FIGUERES AVE STE 365
City	SAN JOSE
State	CA
ZIP	95116
Phone	408 926-8100
CertificateType	4
CertificateEffectiveDate	11/5/2023
CertificateExpirationDate	11/4/2025
FacilityType	Waiver

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