CLIA lab
CLIA 05D0576828: Providence ST Jude Heritage Plaza Stat Lab
Fullerton, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0576828 belongs to Providence ST Jude Heritage Plaza Stat Lab in Fullerton, CA.
Certificate of Accreditation, effective December 23, 2025, expires December 22, 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 Accreditation
- Certificate effective
- December 23, 2025
- Certificate expiration
- December 22, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 7, 1993
- Facility type
- Other
- Ownership (control type)
- Religious affiliation
- Lab classification
- CLIA laboratory
- Accrediting organizations
- COLA
- Directly affiliated labs
- 1
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D0576828
- Lab name
- Providence ST Jude Heritage Plaza Stat Lab
- Address
- 2141 N Harbor Blvd Ste 17000, Fullerton, CA 92835
- Phone
- (657) 236-0902
Annual test volume the lab reported
- Tests under accreditation
- 138,527
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Fullerton, CA
- 1510 East Commonwealth Avenue Opco LLCCertificate of Waiver, Assisted living facility05D2323775
- Adjustable Care Life IncCertificate of Waiver, Hospice05D2174994
- Advanced SkincareCertificate of Compliance, Physician office05D0953069
- Alliance Surgery CenterCertificate of Waiver, Ambulatory surgery center05D1005792
- Angel Fullerton Medical GroupCertificate of Waiver, Physician office05D2269245
- Ascada HealthCertificate of Waiver, Physician office05D2272243
- At Home Dialysis LLCCertificate of Waiver, Other05D2291721
- Bastanchury DialysisCertificate of Waiver, End stage renal disease dialysis facility05D2068431
- Berkey Group, PC DBA Gameday Men's HealthCertificate of Accreditation, Physician office05D2310681
- Bethel Family Medical GroupCertificate of Waiver, Physician office05D2089418
Related
Questions
What is the CLIA number for Providence ST Jude Heritage Plaza Stat Lab in Fullerton?
05D0576828, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Providence ST Jude Heritage Plaza Stat Lab hold?
A Certificate of Accreditation, according to the CMS file.
When does CLIA 05D0576828 expire?
The CMS file lists December 22, 2027 as the certificate expiration date; the certificate took effect December 23, 2025.