05D2064991 CLIA NUMBER - MICHAEL SHEETY MD INC

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Laboratory Demographics

CLIA Number: 05D2064991

Facility Name: MICHAEL SHEETY MD INC

Facility Address:
2010 E 1ST ST STE 160
SANTA ANA, CA
ZIP 92705
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Facility Phone Number: 714 647-1200

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1871578120

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	05D2064991
LAB Type	Physician Office
Facility Name	MICHAEL SHEETY MD INC
Street	2010 E 1ST ST STE 160
City	SANTA ANA
State	CA
ZIP	92705
Phone	714 647-1200
CertificateType	4
CertificateEffectiveDate	8/30/2023
CertificateExpirationDate	8/29/2025
FacilityType	Waiver

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