45D2278635 CLIA NUMBER - SHARPE MEDICAL GROUP

Laboratory Demographics

CLIA Number: 45D2278635

Facility Name: SHARPE MEDICAL GROUP

Facility Address:
1011 S HARWOOD ST #439
DALLAS, TX
ZIP 75201
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Facility Phone Number: 325 310-6310

Facility Type: Other - TRAVELING PHYSICIAN

Certificate Type: Waiver

NPI Number: 1376320101

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2278635
LAB Type	Other - TRAVELING PHYSICIAN
Facility Name	SHARPE MEDICAL GROUP
Street	1011 S HARWOOD ST #439
City	DALLAS
State	TX
ZIP	75201
Phone	325 310-6310
CertificateType	4
CertificateEffectiveDate	3/21/2023
CertificateExpirationDate	3/20/2025
FacilityType	Waiver

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