05D2012105 CLIA NUMBER - EDGAR J STANLEY, MD INC A MEDICAL CORPORATION

Laboratory Demographics

  • CLIA Code: 05D2012105
  • Facility Name: EDGAR J STANLEY, MD INC A MEDICAL CORPORATION
  • Facility Address: 1180 N INDIAN CANYON DR E425
    PALM SPRINGS, CA
    ZIP 92262
  • Facility Phone: 760 322-7900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EDGAR J. STANLEY
  • NPI Number: 1184688624
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2012105
LAB Type Physician Office
Facility Name EDGAR J STANLEY, MD INC A MEDICAL CORPORATION
Street 1180 N INDIAN CANYON DR E425
City PALM SPRINGS
State CA
ZIP 92262
Phone 760 322-7900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2024
Certificate Expiration Date 8/29/2026
Facility Type Physician Office
Lab Director EDGAR J. STANLEY

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