45D2121846 CLIA NUMBER - SHUBHA SHETTY MD PA

Laboratory Demographics

  • CLIA Code: 45D2121846
  • Facility Name: SHUBHA SHETTY MD PA
  • Facility Address: 4502 RIVERSTONE BLVD SUITE 1003
    MISSOURI CITY, TX
    ZIP 77459
  • Facility Phone: 972 904-7683
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHUBHA SHETTY
  • NPI Number: 1760645295
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2121846
LAB Type Physician Office
Facility Name SHUBHA SHETTY MD PA
Street 4502 RIVERSTONE BLVD SUITE 1003
City MISSOURI CITY
State TX
ZIP 77459
Phone 972 904-7683
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2024
Certificate Expiration Date 11/14/2026
Facility Type Physician Office
Lab Director SHUBHA SHETTY

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