CLIA lab
CLIA 05D0970609: Providence Imperial Brea Facility
Brea, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0970609 belongs to Providence Imperial Brea Facility in Brea, CA.
Certificate of Waiver, effective November 15, 2025, expires November 14, 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
- November 15, 2025
- Certificate expiration
- November 14, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 18, 2000
- Facility type
- Physician office
- Ownership (control type)
- Religious affiliation
- 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
- 05D0970609
- Lab name
- Providence Imperial Brea Facility
- Address
- 955 W Imperial Hwy, Brea, CA 92821
- Phone
- (714) 449-6900
- Fax
- (714) 449-6913
Annual test volume the lab reported
- Waived tests
- 3,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Providence Imperial Brea Facility in Brea?
05D0970609, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Providence Imperial Brea Facility hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0970609 expire?
The CMS file lists November 14, 2027 as the certificate expiration date; the certificate took effect November 15, 2025.