05D0890250 CLIA NUMBER - ERNESTO R MILLAN, MD PEDIATRICS

Laboratory Demographics

  • CLIA Code: 05D0890250
  • Facility Name: ERNESTO R MILLAN, MD PEDIATRICS
  • Facility Address: 39000 BOB HOPE DR KIEWITT 211
    RANCHO MIRAGE, CA
    ZIP 92270
  • Facility Phone: 619 776-5620
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ERNESTO R. MILLAN
  • NPI Number: 1063595460
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D0890250
LAB Type Physician Office
Facility Name ERNESTO R MILLAN, MD PEDIATRICS
Street 39000 BOB HOPE DR KIEWITT 211
City RANCHO MIRAGE
State CA
ZIP 92270
Phone 619 776-5620
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2024
Certificate Expiration Date 8/14/2026
Facility Type Physician Office
Lab Director ERNESTO R. MILLAN

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