CLIA lab
CLIA 05D0576616: Providence Brea Dermatology
Brea, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0576616 belongs to Providence Brea Dermatology in Brea, CA.
Certificate of Compliance, effective March 7, 2025, expires March 6, 2027.
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 Compliance
- Certificate effective
- March 7, 2025
- Certificate expiration
- March 6, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 1, 1996
- Facility type
- Physician office
- Ownership (control type)
- Religious affiliation
- 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
- 05D0576616
- Lab name
- Providence Brea Dermatology
- Address
- 955 W Imperial Hwy, Ste 200, Brea, CA 92821
- Phone
- (714) 626-6310
- Fax
- (714) 626-6325
Annual test volume the lab reported
- Waived tests
- 200
- Provider-performed microscopy tests
- 150
- Other nonwaived tests
- 850
- Total
- 1,200
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Brookdale BreaCertificate of Waiver, Assisted living facility05D2212222
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Related
Questions
What is the CLIA number for Providence Brea Dermatology in Brea?
05D0576616, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Providence Brea Dermatology hold?
A Certificate of Compliance, according to the CMS file.
When does CLIA 05D0576616 expire?
The CMS file lists March 6, 2027 as the certificate expiration date; the certificate took effect March 7, 2025.