CLIA lab
CLIA 05D0970677: Creekside Internal Med/Sam Khouri MD
Folsom, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0970677 belongs to Creekside Internal Med/Sam Khouri MD in Folsom, CA.
Certificate of Waiver, effective February 22, 2026, expires February 21, 2028.
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
- February 22, 2026
- Certificate expiration
- February 21, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 22, 2000
- 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
- 05D0970677
- Lab name
- Creekside Internal Med/Sam Khouri MD
- Address
- 1580 Creekside Drive, Suite 260, Folsom, CA 95630
- Phone
- (916) 984-7870
- Fax
- (916) 984-7871
Annual test volume the lab reported
- Waived tests
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Bellestar Home Health Care IncCertificate of Waiver, Home health agency05D2148669
- Bingtao Lin MD PCCertificate of Waiver, Physician office05D2159882
- Brookdale FolsomCertificate of Waiver, Assisted living facility05D2215443
- Carbon Health Medical GroupCertificate of Waiver, Physician office05D1052037
- Dentists of FolsomCertificate of Waiver, Other practitioner05D2342946
- Dignity Health Medical FoundationCertificate for Provider-Performed Microscopy Procedures, Physician office05D1063141
- Dignity Health Medical FoundationCertificate for Provider-Performed Microscopy Procedures, Physician office05D2052008
Related
Questions
What is the CLIA number for Creekside Internal Med/Sam Khouri MD in Folsom?
05D0970677, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Creekside Internal Med/Sam Khouri MD hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0970677 expire?
The CMS file lists February 21, 2028 as the certificate expiration date; the certificate took effect February 22, 2026.