CLIA lab
CLIA 05D0710870: Samuel A Bolivar, MD Inc
San Bernardino, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0710870 belongs to Samuel A Bolivar, MD Inc in San Bernardino, CA.
Certificate of Waiver, effective September 1, 2026, expires August 31, 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 of Waiver
- Certificate effective
- September 1, 2026
- Certificate expiration
- August 31, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 3, 1995
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- 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
- 05D0710870
- Lab name
- Samuel A Bolivar, MD Inc
- Address
- 555 West D Street Ste 130, San Bernardino, CA 92410
- Phone
- (909) 888-8154
- Fax
- (909) 888-9940
Annual test volume the lab reported
- Waived tests
- 1,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Advanced Healthcare for WomenCertificate of Waiver, Other practitioner05D2301657
- Ajay G Meka MD IncCertificate of Waiver, Physician office05D2172605
- Alejandro Pediatrics IncCertificate of Waiver, Physician office05D0980884
- All Ives Matter HospiceCertificate of Waiver, Hospice05D2197088
- All in One Home Health Agency IncCertificate of Waiver, Home health agency05D2041505
- Ally Hospice CorporationCertificate of Waiver, Hospice05D2163100
- Alta Hospice of CaliforniaCertificate of Waiver, Hospice05D2274268
- Amalfi Hospice Care, IncCertificate of Waiver, Hospice05D2160118
- Apple Urgent CareCertificate of Waiver, Physician office05D2284437
Related
Questions
What is the CLIA number for Samuel A Bolivar, MD Inc in San Bernardino?
05D0710870, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Samuel A Bolivar, MD Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0710870 expire?
The CMS file lists August 31, 2028 as the certificate expiration date; the certificate took effect September 1, 2026.