CLIA lab
CLIA 05D0958505: Lake Los Angeles Community Clinic
Lake Los Angeles, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0958505 belongs to Lake Los Angeles Community Clinic in Lake Los Angeles, CA.
Certificate of Waiver, effective March 19, 2025, expires March 18, 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
- March 19, 2025
- Certificate expiration
- March 18, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- March 19, 1999
- Facility type
- Community clinic
- Ownership (control type)
- Government, county
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 4
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D0958505
- Lab name
- Lake Los Angeles Community Clinic
- Address
- 16921 Avenue O, Ste G, Lake Los Angeles, CA 93591
- Phone
- (661) 471-4122
- Fax
- (661) 524-2960
Annual test volume the lab reported
- Waived tests
- 25
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Related
Questions
What is the CLIA number for Lake Los Angeles Community Clinic in Lake Los Angeles?
05D0958505, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Lake Los Angeles Community Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0958505 expire?
The CMS file lists March 18, 2027 as the certificate expiration date; the certificate took effect March 19, 2025.