CLIA lab
CLIA 05D0897771: Adel A Boutros, MD
Lake Forest, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0897771 belongs to Adel A Boutros, MD in Lake Forest, CA.
Certificate of Waiver, effective February 3, 2025, expires February 2, 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
- February 3, 2025
- Certificate expiration
- February 2, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 14, 1995
- Facility type
- Physician office
- 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
- 05D0897771
- Lab name
- Adel A Boutros, MD
- Address
- 24432 Muirlands Blvd, Ste 101, Lake Forest, CA 92630
- Phone
- (949) 951-9399
- Fax
- (949) 951-9403
Annual test volume the lab reported
- Waived tests
- 850
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Alcon LaboratoriesCertificate of Waiver, Other05D2279166
- Coastline EndocrinologyCertificate of Waiver, Physician office05D2338903
- Concentra Lake ForestCertificate of Waiver, Physician office05D0958933
- Foothill Gateway Surgery Center LLCCertificate of Waiver, Ambulatory surgery center05D1024936
- Foothill Surgical InstituteCertificate of Waiver, Ambulatory surgery center05D1030512
- Freedom Village Health Care CenterCertificate of Waiver, Skilled nursing or nursing facility05D0880891
- Genomic Testing CooperativeCertificate of Accreditation, Independent05D2111917
Related
Questions
What is the CLIA number for Adel A Boutros, MD in Lake Forest?
05D0897771, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Adel A Boutros, MD hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0897771 expire?
The CMS file lists February 2, 2027 as the certificate expiration date; the certificate took effect February 3, 2025.