05D2155660 CLIA NUMBER - MIRACLE MILES PEDIATRICS

Laboratory Demographics

  • CLIA Code: 05D2155660
  • Facility Name: MIRACLE MILES PEDIATRICS
  • Facility Address: 6310 SAN VICENTE BLVD STE 290
    LOS ANGELES, CA
    ZIP 90048
  • Facility Phone: 323 938-7294
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ASNANI ASNANI
  • NPI Number: 1962874131
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D2155660
LAB Type Physician Office
Facility Name MIRACLE MILES PEDIATRICS
Street 6310 SAN VICENTE BLVD STE 290
City LOS ANGELES
State CA
ZIP 90048
Phone 323 938-7294
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Physician Office
Lab Director ASNANI ASNANI

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