05D2287714 CLIA NUMBER - MOXIE BIRTH

Laboratory Demographics

  • CLIA Code: 05D2287714
  • Facility Name: MOXIE BIRTH
  • Facility Address: 1416 EL CENTRO ST SUITE 100
    SOUTH PASADENA, CA
    ZIP 91030
  • Facility Phone: 626 399-0649
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BENTE KAISER
  • NPI Number: 1073223483
  • Taxonomy: 261QB0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2287714
LAB Type Physician Office
Facility Name MOXIE BIRTH
Street 1416 EL CENTRO ST SUITE 100
City SOUTH PASADENA
State CA
ZIP 91030
Phone 626 399-0649
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 8/16/2025
Certificate Expiration Date 8/15/2027
Facility Type Physician Office
Lab Director BENTE KAISER

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