CLIA lab
CLIA 05D0906600: Jason Boutros, MD Inc
Pasadena, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0906600 belongs to Jason Boutros, MD Inc in Pasadena, CA.
Certificate of Waiver, effective October 3, 2025, expires October 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
- October 3, 2025
- Certificate expiration
- October 2, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 3, 1995
- 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
- 05D0906600
- Lab name
- Jason Boutros, MD Inc
- Address
- 2554 E Washington Blvd Ste A, Pasadena, CA 91107
- Phone
- (626) 798-8923
- Fax
- (626) 798-0258
Annual test volume the lab reported
- Waived tests
- 99
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 Jason Boutros, MD Inc in Pasadena?
05D0906600, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Jason Boutros, MD Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0906600 expire?
The CMS file lists October 2, 2027 as the certificate expiration date; the certificate took effect October 3, 2025.