05D2142600 CLIA NUMBER - PACIFIC PAIN PHYSICIANS

Laboratory Demographics

  • CLIA Code: 05D2142600
  • Facility Name: PACIFIC PAIN PHYSICIANS
  • Facility Address: 1551 BISHOP ST, BLDG B STE 210
    SAN LUIS OBISPO, CA
    ZIP 93401
  • Facility Phone: 805 563-0363
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RALPH MOZINGO
  • NPI Number: 1033606553
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2142600
LAB Type Physician Office
Facility Name PACIFIC PAIN PHYSICIANS
Street 1551 BISHOP ST, BLDG B STE 210
City SAN LUIS OBISPO
State CA
ZIP 93401
Phone 805 563-0363
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/16/2024
Certificate Expiration Date 1/15/2026
Facility Type Physician Office
Lab Director RALPH MOZINGO

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