05D2090549 CLIA NUMBER - MICHAEL MOON, MD AMC

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Laboratory Demographics

CLIA Number: 05D2090549

Facility Name: MICHAEL MOON, MD AMC

Facility Address:
3939 RUFFIN RD #11
SAN DIEGO, CA
ZIP 92123
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Facility Phone Number: 858 202-1546

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1619014230

Taxonomy: 208VP0014X - Pain Medicine
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

CLIA Record

Field Name	Field Value
CLIA Number	05D2090549
LAB Type	Physician Office
Facility Name	MICHAEL MOON, MD AMC
Street	3939 RUFFIN RD #11
City	SAN DIEGO
State	CA
ZIP	92123
Phone	858 202-1546
CertificateType	4
CertificateEffectiveDate	1/26/2023
CertificateExpirationDate	1/25/2025
FacilityType	Waiver

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