45D1104780 CLIA NUMBER - SHANNON DE SHAZO, MD

Laboratory Demographics

  • CLIA Code: 45D1104780
  • Facility Name: SHANNON DE SHAZO, MD
  • Facility Address: 5236 W UNIVERSITY DRIVE # 3200
    MCKINNEY, TX
    ZIP 75071
  • Facility Phone: 972 548-1717
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SHANNON L. DESHAZO
  • NPI Number: 1427261288
  • Taxonomy: 207Q00000X - Family Medicine

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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
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/10/2025
Certificate Expiration Date 9/9/2027
Facility Type Physician Office
Lab Director SHANNON L. DESHAZO

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This page was last updated on: 9/29/2025