33D2046617 CLIA NUMBER - IDAN SHARON, MD

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Laboratory Demographics

CLIA Number: 33D2046617

Facility Name: IDAN SHARON, MD

Facility Address:
6917 SHORE ROAD
BROOKLYN, NY
ZIP 11209
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Facility Phone Number: 718 680-8105

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1205852845

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	33D2046617
LAB Type	Physician Office
Facility Name	IDAN SHARON, MD
Street	6917 SHORE ROAD
City	BROOKLYN
State	NY
ZIP	11209
Phone	718 680-8105
CertificateType	4
CertificateEffectiveDate	9/7/2022
CertificateExpirationDate	9/6/2024
FacilityType	Waiver

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