CLIA lab
CLIA 05D0912539: High Desert State Prison Laboratory
Susanville, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0912539 belongs to High Desert State Prison Laboratory in Susanville, CA.
Certificate of Waiver, effective June 26, 2025, expires June 25, 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
- June 26, 2025
- Certificate expiration
- June 25, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- March 6, 1996
- Facility type
- Other
- 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
- 05D0912539
- Lab name
- High Desert State Prison Laboratory
- Address
- 475-750 Rice Canyon Rd, Susanville, CA 96130
- Phone
- (530) 251-5100
- Fax
- (530) 252-5018
Annual test volume the lab reported
- Waived tests
- 50,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Susanville, CA
- Banner HealthCertificate for Provider-Performed Microscopy Procedures, Physician office05D2119306
- Banner Lassen Medical CenterCertificate of Accreditation, Hospital05D0677283
- CF Susanville, LLCCertificate of Waiver, Skilled nursing or nursing facility05D0671777
- Diamond View VA ClinicCertificate of Accreditation, Community clinic05D2028005
- Hal Meadows MDCertificate of Waiver, Physician office05D0618634
- Keith Mark Gross MD IncCertificate of Compliance, Physician office05D2024231
- Lassen County Public Health DepartmentCertificate of Waiver, Public health laboratory05D0707206
- Lassen Indian Health CenterCertificate of Waiver, Other05D0684082
- Northeastern Rural Health ClinicsCertificate of Waiver, Federally qualified health center05D0618660
- Walgreens 10421Certificate of Waiver, Pharmacy05D2308164
Related
Questions
What is the CLIA number for High Desert State Prison Laboratory in Susanville?
05D0912539, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does High Desert State Prison Laboratory hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0912539 expire?
The CMS file lists June 25, 2027 as the certificate expiration date; the certificate took effect June 26, 2025.