CLIA lab
CLIA 05D0611996: Mendocino Coast Adventist Health
Fort Bragg, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0611996 belongs to Mendocino Coast Adventist Health in Fort Bragg, CA.
Certificate of Waiver, effective July 31, 2025, expires July 30, 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
- July 31, 2025
- Certificate expiration
- July 30, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 14, 1993
- Facility type
- Rural health clinic
- Ownership (control type)
- Other
- 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
- 05D0611996
- Lab name
- Mendocino Coast Adventist Health
- Additional name
- Medical Offices
- Address
- 721 River Dr Ste A, Fort Bragg, CA 95437
- Phone
- (707) 961-4659
Annual test volume the lab reported
- Waived tests
- 1,200
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Fort Bragg, CA
- Adventist Health Mendocino CoastCertificate of Accreditation, Hospital05D0612009
- Adventist Health Ukiah Valley (Ahuv)Certificate of Waiver, Rural health clinic05D0612017
- Dci - Fort BraggCertificate of Waiver, End stage renal disease dialysis facility05D1057444
- Safeway Pharmacy #978Certificate of Waiver, Pharmacy05D2064268
- Sherwood Oaks Post Acute Care LLCCertificate of Waiver, Skilled nursing or nursing facility05D0612016
Related
Questions
What is the CLIA number for Mendocino Coast Adventist Health in Fort Bragg?
05D0611996, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Mendocino Coast Adventist Health hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0611996 expire?
The CMS file lists July 30, 2027 as the certificate expiration date; the certificate took effect July 31, 2025.