36D2054545 CLIA NUMBER - SIMONA L MOORE CNP LLC

Laboratory Demographics

  • CLIA Code: 36D2054545
  • Facility Name: SIMONA L MOORE CNP LLC
  • Facility Address: 206 S MULBERRY ST STE A
    MOUNT VERNON, OH
    ZIP 43050
  • Facility Phone: 740 326-1231
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SIMONA L. MOORE
  • NPI Number: 1679502181
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 36D2054545
LAB Type Physician Office
Facility Name SIMONA L MOORE CNP LLC
Street 206 S MULBERRY ST STE A
City MOUNT VERNON
State OH
ZIP 43050
Phone 740 326-1231
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2025
Certificate Expiration Date 9/10/2027
Facility Type Physician Office
Lab Director SIMONA L. MOORE

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