CLIA lab
CLIA 05D0558587: Country Manor Healthcare
Lake View Terrace, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0558587 belongs to Country Manor Healthcare in Lake View Terrace, CA.
Certificate of Waiver, effective September 1, 2026, expires August 31, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- September 1, 2026
- Certificate expiration
- August 31, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 13, 1993
- Facility type
- Skilled nursing or nursing facility
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D0558587
- Lab name
- Country Manor Healthcare
- Address
- 11723 Fenton Ave, Lake View Terrace, CA 91342
- Phone
- (818) 899-0251
- Fax
- (818) 890-5400
Annual test volume the lab reported
- Waived tests
- 27,400
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Care facility at this address
- Country Manor HealthcareCMS Care Compare ratings for the facility at the same street address
Other labs in Lake View Terrace, CA
Related
Questions
What is the CLIA number for Country Manor Healthcare in Lake View Terrace?
05D0558587, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Country Manor Healthcare hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0558587 expire?
The CMS file lists August 31, 2028 as the certificate expiration date; the certificate took effect September 1, 2026.