CLIA lab
CLIA 05D0958933: Concentra Lake Forest
Lake Forest, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0958933 belongs to Concentra Lake Forest in Lake Forest, CA.
Certificate of Waiver, effective March 30, 2025, expires March 29, 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 30, 2025
- Certificate expiration
- March 29, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- March 30, 1999
- 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
- 05D0958933
- Lab name
- Concentra Lake Forest
- Address
- 22741 Lambert St, Ste 1608, Lake Forest, CA 92630
- Phone
- (949) 581-3011
- Fax
- (949) 581-6457
Annual test volume the lab reported
- Waived tests
- 2,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Adel A Boutros, MDCertificate of Waiver, Physician office05D0897771
- Alcon LaboratoriesCertificate of Waiver, Other05D2279166
- Coastline EndocrinologyCertificate of Waiver, Physician office05D2338903
- 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 Concentra Lake Forest in Lake Forest?
05D0958933, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Concentra Lake Forest hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0958933 expire?
The CMS file lists March 29, 2027 as the certificate expiration date; the certificate took effect March 30, 2025.