CLIA lab
CLIA 05D0579775: Providence Tustin
Tustin, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0579775 belongs to Providence Tustin in Tustin, CA.
Certificate of Waiver, 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 Waiver
- Certificate effective
- December 23, 2025
- Certificate expiration
- December 22, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- December 28, 1992
- Facility type
- Physician office
- Ownership (control type)
- Religious affiliation
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 2
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D0579775
- Lab name
- Providence Tustin
- Address
- 1095 Irvine Blvd, Tustin, CA 92780
- Phone
- (714) 505-7710
- Fax
- (714) 505-7108
Annual test volume the lab reported
- Waived tests
- 2,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Tustin, CA
- Allied Surgery CenterCertificate of Waiver, Ambulatory surgery center05D2019815
- Alyssa Youngjee Kim, MDCertificate of Compliance, Physician office05D0946552
- Americana Adult Day CenterCertificate of Waiver, Other05D2265453
- Angenida Hospice LLCCertificate of Waiver, Hospice05D2203465
- Apex Health Providers DBA Afc Urgent Care TustinCertificate of Waiver, Other05D2325752
- Bambhania Medical CorporationCertificate of Waiver, Physician office05D2166376
- CK Family Therapy and Counseling Services, PCCertificate of Waiver, Other05D2332117
- Ccts Shared LaboratoryCertificate of Waiver, Physician office05D0578793
- Connections Menatal HealthCertificate of Waiver, Other05D2303810
- Cornerstone of Southern CaliforniaCertificate of Waiver, Other05D2083439
Related
Questions
What is the CLIA number for Providence Tustin in Tustin?
05D0579775, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Providence Tustin hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0579775 expire?
The CMS file lists December 22, 2027 as the certificate expiration date; the certificate took effect December 23, 2025.