05D1053348 CLIA NUMBER - TIMOTHY J COEN MD PC DBA MISSION FAMILY CARE

Laboratory Demographics

  • CLIA Code: 05D1053348
  • Facility Name: TIMOTHY J COEN MD PC DBA MISSION FAMILY CARE
  • Facility Address: 706 SOUTH MAIN AVE
    FALLBROOK, CA
    ZIP 92028
  • Facility Phone: 760 451-3500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TIMOTHY J. COEN MD
  • NPI Number: 1174573562
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1053348
LAB Type Physician Office
Facility Name TIMOTHY J COEN MD PC DBA MISSION FAMILY CARE
Street 706 SOUTH MAIN AVE
City FALLBROOK
State CA
ZIP 92028
Phone 760 451-3500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2024
Certificate Expiration Date 4/19/2026
Facility Type Physician Office
Lab Director TIMOTHY J. COEN MD

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