45D1104780 CLIA NUMBER - SHANNON DE SHAZO, MD

Laboratory Demographics

CLIA Number: 45D1104780

Facility Name: SHANNON DE SHAZO, MD

Facility Address:
5236 W UNIVERSITY DRIVE # 3200
MCKINNEY, TX
ZIP 75071
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Facility Phone Number: 972 548-1717

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1427261288

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	45D1104780
LAB Type	Physician Office
Facility Name	SHANNON DE SHAZO, MD
Street	5236 W UNIVERSITY DRIVE # 3200
City	MCKINNEY
State	TX
ZIP	75071
Phone	972 548-1717
CertificateType	3
CertificateEffectiveDate	9/10/2023
CertificateExpirationDate	9/9/2025
FacilityType	PPMP

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