CLIA lab
CLIA 05D0862779: Adventist Health Lodi Memorial
Lodi, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0862779 belongs to Adventist Health Lodi Memorial in Lodi, CA.
Certificate of Waiver, effective October 22, 2025, expires October 21, 2027.
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
- October 22, 2025
- Certificate expiration
- October 21, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 26, 1993
- Facility type
- Community clinic
- 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
- 05D0862779
- Lab name
- Adventist Health Lodi Memorial
- Address
- 1235 W Vine St Ste 20, Lodi, CA 95240
- Phone
- (209) 339-7886
- Fax
- (209) 339-7509
Annual test volume the lab reported
- Waived tests
- 2,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Lodi, CA
- Adventist Health Lodi MemorialCertificate of Accreditation, Hospital05D0609686
- Adventist Health Lodi MemorialCertificate of Waiver, Physician office05D0885857
- Adventist Health Lodi MemorialCertificate of Waiver, Physician office05D2035089
- Adventist Health Lodi MemorialCertificate of Waiver, Physician office05D2095753
- Adventist Health Physicians NetworkCertificate of Waiver, Physician office05D1097139
- Adventist Health Physicians NetworkCertificate of Waiver, Physician office05D2120316
- Adventist Health Physicians NetworkCertificate of Waiver, Physician office05D2341365
- Adventist Health Physicians Network - Cancer CareCertificate of Waiver, Physician office05D2212313
- Adventist Health Physicians Network - Lodi UrologyCertificate for Provider-Performed Microscopy Procedures, Physician office05D2154128
- Aegis Treatment Centers, LLCCertificate of Waiver, Other05D2102212
Related
Questions
What is the CLIA number for Adventist Health Lodi Memorial in Lodi?
05D0862779, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Adventist Health Lodi Memorial hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0862779 expire?
The CMS file lists October 21, 2027 as the certificate expiration date; the certificate took effect October 22, 2025.