CLIA lab
CLIA 05D0613049: Southern Trinity Health Services Inc
Mad River, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0613049 belongs to Southern Trinity Health Services Inc in Mad River, CA.
Certificate of Waiver, effective November 16, 2024, expires November 15, 2026.
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
- November 16, 2024
- Certificate expiration
- November 15, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 16, 1994
- Facility type
- Federally qualified health center
- Ownership (control type)
- Other
- Lab classification
- CLIA laboratory
- 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
- 05D0613049
- Lab name
- Southern Trinity Health Services Inc
- Address
- 321 Van Duzen Rd, Mad River, CA 95552
- Phone
- (707) 764-5617
- Fax
- (707) 783-3511
Annual test volume the lab reported
- Waived tests
- 290
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Related
Questions
What is the CLIA number for Southern Trinity Health Services Inc in Mad River?
05D0613049, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Southern Trinity Health Services Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0613049 expire?
The CMS file lists November 15, 2026 as the certificate expiration date; the certificate took effect November 16, 2024.