CLIA lab
CLIA 05D0612494: Fountaingrove Lab - ST Joseph Health
Santa Rosa, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0612494 belongs to Fountaingrove Lab - ST Joseph Health in Santa Rosa, CA.
Certificate of Accreditation, effective July 29, 2025, expires July 28, 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
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Accreditation
- Certificate effective
- July 29, 2025
- Certificate expiration
- July 28, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- December 16, 1992
- Facility type
- Other
- Ownership (control type)
- Religious affiliation
- Lab classification
- CLIA laboratory
- Accrediting organizations
- The Joint Commission
- Directly affiliated labs
- 4
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D0612494
- Lab name
- Fountaingrove Lab - ST Joseph Health
- Additional name
- DBA Providence Santa Rosa Memorial Hospital
- Address
- 3555 Round Barn Circle, Santa Rosa, CA 95403
- Phone
- (707) 324-3722
Annual test volume the lab reported
- Waived tests
- 500
- Tests under accreditation
- 80,000
- Total
- 80,500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Santa Rosa, CA
- 151 Sotoyme Hospital DBACertificate of Waiver, Hospital05D2135659
- 4th Street Laser & Surgery CenterCertificate of Waiver, Ambulatory surgery center05D1008140
- Advanced Home Health Northbay, IncCertificate of Waiver, Home health agency05D2068496
- Anjani Thakur , MD. Inc.Certificate of Waiver, Physician office05D2278394
- Arbol Healthcare Center of Santa RosaCertificate of Waiver, Skilled nursing or nursing facility05D0985872
- ArtemedicaCertificate of Waiver, Physician office05D2030692
- Aurora Behavioral HealthcareCertificate of Waiver, Other05D2053033
- Bennett Valley ICF DD H IncCertificate of Waiver, Intermediate care facility for individuals with intellectual disabilities05D0998299
- Bridges Pregnancy ClinicCertificate of Waiver, Community clinic05D0978274
- Brookdale ChanateCertificate of Waiver, Assisted living facility05D2215559
Related
Questions
What is the CLIA number for Fountaingrove Lab - ST Joseph Health in Santa Rosa?
05D0612494, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Fountaingrove Lab - ST Joseph Health hold?
A Certificate of Accreditation, according to the CMS file.
When does CLIA 05D0612494 expire?
The CMS file lists July 28, 2027 as the certificate expiration date; the certificate took effect July 29, 2025.