33D2051136 CLIA NUMBER - IDAN SHARON, MD

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Laboratory Demographics

CLIA Number: 33D2051136

Facility Name: IDAN SHARON, MD

Facility Address:
345 SEAVIEW AVENUE
STATEN ISLAND, NY
ZIP 10305
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Facility Phone Number: 212 945-4554

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1689845315

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	33D2051136
LAB Type	Physician Office
Facility Name	IDAN SHARON, MD
Street	345 SEAVIEW AVENUE
City	STATEN ISLAND
State	NY
ZIP	10305
Phone	212 945-4554
CertificateType	4
CertificateEffectiveDate	12/13/2022
CertificateExpirationDate	12/12/2024
FacilityType	Waiver

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