CLIA lab
CLIA 05D0954551: Don Pedro Family Practice
La Grange, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0954551 belongs to Don Pedro Family Practice in La Grange, CA.
Certificate of Waiver, effective December 1, 2024, expires November 30, 2026.
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
- December 1, 2024
- Certificate expiration
- November 30, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- December 1, 1998
- 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
- 05D0954551
- Lab name
- Don Pedro Family Practice
- Address
- 3191 El Prado Suite D, La Grange, CA 95329
- Phone
- (209) 852-2764
Annual test volume the lab reported
- Waived tests
- 250
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Related
Questions
What is the CLIA number for Don Pedro Family Practice in La Grange?
05D0954551, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Don Pedro Family Practice hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0954551 expire?
The CMS file lists November 30, 2026 as the certificate expiration date; the certificate took effect December 1, 2024.