05D1094024 CLIA NUMBER - MIRAGE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D1094024
  • Facility Name: MIRAGE SURGERY CENTER
  • Facility Address: 71-949 HWY 111, STE 300
    RANCHO MIRAGE, CA
    ZIP 92270
  • Facility Phone: 760 568-2211
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ANDREW P. ORDON, MD
  • NPI Number: 1932350238
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1094024
LAB Type Ambulatory Surgery Center
Facility Name MIRAGE SURGERY CENTER
Street 71-949 HWY 111, STE 300
City RANCHO MIRAGE
State CA
ZIP 92270
Phone 760 568-2211
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/8/2025
Certificate Expiration Date 1/7/2027
Facility Type Ambulatory Surgery Center
Lab Director ANDREW P. ORDON, MD

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