45D2121846 CLIA NUMBER - SHUBHA SHETTY MD PA

Laboratory Demographics

CLIA Number: 45D2121846

Facility Name: SHUBHA SHETTY MD PA

Facility Address:
4502 RIVERSTONE BLVD SUITE 1003
MISSOURI CITY, TX
ZIP 77459
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Facility Phone Number: 972 904-7683

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1760645295

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	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
CertificateType	4
CertificateEffectiveDate	11/15/2022
CertificateExpirationDate	11/14/2024
FacilityType	Waiver

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