05D2280119 CLIA NUMBER - MIRAMAR HEALTH, LLC

Laboratory Demographics

CLIA Number: 05D2280119

Facility Name: MIRAMAR HEALTH, LLC

Facility Address:
24851 VIA SANTA CRUZ
MISSION VIEJO, CA
ZIP 92692
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Facility Phone Number: 949 334-5961

Facility Type: Other - RES. DETOX TREATMENT

Certificate Type: Waiver

NPI Number: 1528799665

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	05D2280119
LAB Type	Other - RES. DETOX TREATMENT
Facility Name	MIRAMAR HEALTH, LLC
Street	24851 VIA SANTA CRUZ
City	MISSION VIEJO
State	CA
ZIP	92692
Phone	949 334-5961
CertificateType	4
CertificateEffectiveDate	4/13/2023
CertificateExpirationDate	4/12/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024