CLIA lab
CLIA 05D0704200: Sutter Gould Medical Foundation -
Tracy, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0704200 belongs to Sutter Gould Medical Foundation - in Tracy, CA.
Certificate for Provider-Performed Microscopy Procedures, effective September 30, 2026, expires September 29, 2028.
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 for Provider-Performed Microscopy Procedures
- Certificate effective
- September 30, 2026
- Certificate expiration
- September 29, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- December 21, 1992
- Facility type
- Physician office
- Ownership (control type)
- Private
- 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
- 05D0704200
- Lab name
- Sutter Gould Medical Foundation -
- Additional name
- Tracy Dermatology
- Address
- 445 W Eaton Ave, Ste 110 B, Tracy, CA 95376
- Phone
- (209) 485-5463
Annual test volume the lab reported
- Provider-performed microscopy tests
- 500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Ameriprime Home Health CareCertificate of Waiver, Home health agency05D2267485
- Co Occupational Medical PartnersCertificate of Waiver, Physician office05D2194804
- Crisis Pregnancy Center of TracyCertificate of Waiver, Other05D1031050
- Delta Eye Medical Group, Inc.Certificate of Waiver, Physician office05D2060650
- Golden State DermatologyCertificate of Compliance, Physician office05D2228655
- Grant Line DialysisCertificate of Waiver, End stage renal disease dialysis facility05D2182931
- Great Valley Home Health LLCCertificate of Waiver, Home health agency05D2181717
- Heart 2 Heart Home Health CareCertificate of Waiver, Home health agency05D2314591
Related
Questions
What is the CLIA number for Sutter Gould Medical Foundation - in Tracy?
05D0704200, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Sutter Gould Medical Foundation - hold?
A Certificate for Provider-Performed Microscopy Procedures, according to the CMS file.
When does CLIA 05D0704200 expire?
The CMS file lists September 29, 2028 as the certificate expiration date; the certificate took effect September 30, 2026.