11D2184068 CLIA NUMBER - SHIKHA SHAH, MD LLC DBA PRESTIGE FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 11D2184068

Facility Name: SHIKHA SHAH, MD LLC DBA PRESTIGE FAMILY MEDICINE

Facility Address:
6200 BRADLEY PARK DRIVE
COLUMBUS, GA
ZIP 31904
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Facility Phone Number: 706 315-3515

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1457989618

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	11D2184068
LAB Type	Physician Office
Facility Name	SHIKHA SHAH, MD LLC DBA PRESTIGE FAMILY MEDICINE
Street	6200 BRADLEY PARK DRIVE
City	COLUMBUS
State	GA
ZIP	31904
Phone	706 315-3515
CertificateType	4
CertificateEffectiveDate	5/14/2024
CertificateExpirationDate	5/13/2026
FacilityType	Waiver

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