05D2187311 CLIA NUMBER - MARK SOFONIO MD

Laboratory Demographics

  • CLIA Code: 05D2187311
  • Facility Name: MARK SOFONIO MD
  • Facility Address: 71885 HIGHWAY 111
    RANCHO MIRAGE, CA
    ZIP 92270
  • Facility Phone: 760 341-5555
  • Facility Type: Other - PLASTIC SURG CLINIC
  • Facility Type: Waiver
  • Lab Director: MARK V. SOFONIO
  • NPI Number: 1700868718
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 05D2187311
LAB Type Other - PLASTIC SURG CLINIC
Facility Name MARK SOFONIO MD
Street 71885 HIGHWAY 111
City RANCHO MIRAGE
State CA
ZIP 92270
Phone 760 341-5555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2024
Certificate Expiration Date 6/28/2026
Facility Type Other - PLASTIC SURG CLINIC
Lab Director MARK V. SOFONIO

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