CLIA lab
CLIA 05D0964089: Permanente Medical Group, Inc
San Rafael, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0964089 belongs to Permanente Medical Group, Inc in San Rafael, CA.
Certificate for Provider-Performed Microscopy Procedures, effective August 18, 2025, expires August 17, 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 for Provider-Performed Microscopy Procedures
- Certificate effective
- August 18, 2025
- Certificate expiration
- August 17, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 18, 1999
- Facility type
- Physician office
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 2
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D0964089
- Lab name
- Permanente Medical Group, Inc
- Additional name
- San Rafael Third Street Lab
- Address
- 1033 3rd Street, San Rafael, CA 94901
- Phone
- (510) 672-1357
Annual test volume the lab reported
- Waived tests
- 1,800
- Provider-performed microscopy tests
- 250
- Total
- 2,050
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in San Rafael, CA
- Aegis Living San RafaelCertificate of Waiver, Assisted living facility05D2332583
- Bayside MarinCertificate of Waiver, Other05D2076223
- Bayside MarinCertificate of Waiver, Comprehensive outpatient rehab facility05D2091514
- Brett V Curtis MDCertificate of Waiver, Physician office05D0872179
- Center Point IncCertificate for Provider-Performed Microscopy Procedures, Comprehensive outpatient rehab facility05D0886299
- Cortica Healthcare Inc MarinCertificate of Waiver, Physician office05D2274367
- David M Tully-Smith, MD, A Medical CorporationCertificate of Waiver, Physician office05D1097391
- Evia Diagnostics Marin LLCCertificate of Waiver, Other05D2273473
- Health Diagnostics of California LLCCertificate of Waiver, Other05D2094888
- Heartwood House LLCCertificate of Waiver, Other05D2220049
Related
Questions
What is the CLIA number for Permanente Medical Group, Inc in San Rafael?
05D0964089, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Permanente Medical Group, Inc hold?
A Certificate for Provider-Performed Microscopy Procedures, according to the CMS file.
When does CLIA 05D0964089 expire?
The CMS file lists August 17, 2027 as the certificate expiration date; the certificate took effect August 18, 2025.