CLIA lab
CLIA 05D0890527: Pelican Bay State Prison Clinical Laboratory
Crescent City, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0890527 belongs to Pelican Bay State Prison Clinical Laboratory in Crescent City, CA.
Certificate of Waiver, effective June 23, 2026, expires June 22, 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
- June 23, 2026
- Certificate expiration
- June 22, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 19, 1994
- Facility type
- Prison
- Ownership (control type)
- Government, state
- 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
- 05D0890527
- Lab name
- Pelican Bay State Prison Clinical Laboratory
- Address
- 5905 Lake Earl Dr, Crescent City, CA 95532
- Phone
- (707) 465-1000
- Fax
- (707) 464-9161
Annual test volume the lab reported
- Waived tests
- 100
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Crescent City, CA
- Aegis Treatment Centers, LLCCertificate of Waiver, Other05D2331642
- Coastal Hospice IncCertificate of Waiver, Hospice05D2303478
- Cole Chiropractic ClinicCertificate of Waiver, Other practitioner05D2091532
- Crescent City Skilled NursingCertificate of Waiver, Skilled nursing or nursing facility05D2149578
- Del Norte Ambulance IncCertificate of Waiver, Mobile lab05D0693295
- Del Norte Community Health CenterCertificate for Provider-Performed Microscopy Procedures, Federally qualified health center05D0676102
- Del Norte County Dept of Health &Certificate of Waiver, Public health laboratory05D1016951
- Del Norte County JailCertificate of Waiver, Prison05D2286723
- Del Norte County JuvenilleCertificate of Waiver, Other05D2284318
- Del Norte Mobile Health ServicesCertificate for Provider-Performed Microscopy Procedures, Federally qualified health center05D2314011
Related
Questions
What is the CLIA number for Pelican Bay State Prison Clinical Laboratory in Crescent City?
05D0890527, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Pelican Bay State Prison Clinical Laboratory hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0890527 expire?
The CMS file lists June 22, 2028 as the certificate expiration date; the certificate took effect June 23, 2026.