MIRAMAR HEALTH INC
NPI 1205371341
Clinic/Center - Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) in Costa Mesa, CA
- Organization
- Clinic/Center
- Rehabilitation, Comprehensive Outpatient...
- CLIA Number: 05D2080625
- CLIA Cert. Type: Independent
- CLIA Exp. Date: 02-23-2026
About MIRAMAR HEALTH INC
This page provides the complete NPI Profile along with additional information for Miramar Health Inc, a provider established in Costa Mesa, California operating as a Clinic/center, focusing in rehabilitation, comprehensive outpatient rehabilitation facility (corf) . The healthcare provider is registered in the NPI registry with number 1205371341 assigned on December 2016. The practitioner's primary taxonomy code is 261QR0401X with license number 300182DP (CA). The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Mr. Derik Brian (Owner)
- NPI
- 1205371341 Verify this NPI
- Provider Name
- MIRAMAR HEALTH INC
- Entity Type
- Organization
- Location Address
- 2165 HARBOR BLVD COSTA MESA, CA 92627
- Location Phone
- (949) 415-7714
- Mailing Address
- 812 EMERALD BAY LAGUNA BEACH, CA 92651
- Mailing Phone
- (949) 370-0771
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-28-2016
- Last Update Date
- 12-28-2016
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
- Taxonomy Code
- 261QR0401X
- Type
- Ambulatory Health Care Facilities
- License No.
- 300182DP
- License State
- CA
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2080625
- Facility Type
- Independent
- Certificate Effective Date
- February 24, 2024
- Certificate Expiration Date
- February 23, 2026
- Laboratory Director
- JOSEPH A. DESANTO
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Miramar Health Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205371341, enumerated as an "organization" on December 28, 2016.
The provider is located at 2165 HARBOR BLVD COSTA MESA, CA 92627 and the phone number is (949) 415-7714.
Clinic/Center with taxonomy code 261QR0401X and a focus in Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF).
