CLIA lab
CLIA 05D0857471: Antonio A Tan Medical Clinic
Moreno Valley, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0857471 belongs to Antonio A Tan Medical Clinic in Moreno Valley, 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
- January 12, 1993
- 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
- 05D0857471
- Lab name
- Antonio A Tan Medical Clinic
- Address
- 12980 Frederick Street, Suite D, Moreno Valley, CA 92553
- Phone
- (951) 485-2744
Annual test volume the lab reported
- Waived tests
- 500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Antonio A Tan Medical Clinic in Moreno Valley?
05D0857471, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Antonio A Tan Medical Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0857471 expire?
The CMS file lists August 31, 2028 as the certificate expiration date; the certificate took effect September 1, 2026.