05D2109290 CLIA NUMBER - JOSEPH MOORE INC

Laboratory Demographics

  • CLIA Code: 05D2109290
  • Facility Name: JOSEPH MOORE INC
  • Facility Address: 975 GARNET AVE
    SAN DIEGO, CA
    ZIP 92109
  • Facility Phone: 619 995-8111
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JOSEPH MOORE
  • NPI Number: 1588035968
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2109290
LAB Type Physician Office
Facility Name JOSEPH MOORE INC
Street 975 GARNET AVE
City SAN DIEGO
State CA
ZIP 92109
Phone 619 995-8111
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/23/2024
Certificate Expiration Date 2/22/2026
Facility Type Physician Office
Lab Director JOSEPH MOORE

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