CLIA lab
CLIA 05D0718873: Ag San Gabriel LLC
San Gabriel, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0718873 belongs to Ag San Gabriel LLC in San Gabriel, 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
- July 14, 1993
- Facility type
- Skilled nursing or nursing facility
- 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
- 05D0718873
- Lab name
- Ag San Gabriel LLC
- Additional name
- DBA Broadway Healthcare Center
- Address
- 112 E Broadway, San Gabriel, CA 91776
- Phone
- (626) 285-2165
- Fax
- (626) 287-4061
Annual test volume the lab reported
- Waived tests
- 7,300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Care facility at this address
- Broadway Healthcare CenterCMS Care Compare ratings for the facility at the same street address
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- Emeral Family Medical ClinicCertificate of Waiver, Physician office05D0996318
- Evergreen Adult Day Health Care CenterCertificate of Waiver, Other05D0994538
- FWD Healthcare Inc DBA 986 Pharmarcy #8037Certificate of Waiver, Pharmacy05D2332179
- Francisco E Rodriguez, DOCertificate of Waiver, Physician office05D2027596
- Green Pine Home Health Care ServicesCertificate of Waiver, Home health agency05D1070324
- Healthcare Partners AffiliatesCertificate of Waiver, Physician office05D0565388
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Questions
What is the CLIA number for Ag San Gabriel LLC in San Gabriel?
05D0718873, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Ag San Gabriel LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0718873 expire?
The CMS file lists August 31, 2028 as the certificate expiration date; the certificate took effect September 1, 2026.