05D2062086 CLIA NUMBER - MORADI MD, FACE BEAUTIFUL INC

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Laboratory Demographics

CLIA Number: 05D2062086

Facility Name: MORADI MD, FACE BEAUTIFUL INC

Facility Address:
2023 W VISTA WAY STE F
VISTA, CA
ZIP 92083
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Facility Phone Number: 760 726-6451

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1245996362

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2062086
LAB Type	Physician Office
Facility Name	MORADI MD, FACE BEAUTIFUL INC
Street	2023 W VISTA WAY STE F
City	VISTA
State	CA
ZIP	92083
Phone	760 726-6451
CertificateType	4
CertificateEffectiveDate	7/10/2023
CertificateExpirationDate	7/9/2025
FacilityType	Waiver

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