CLIA lab
CLIA 05D0989667: Jewish Community Free Clinic
Santa Rosa, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D0989667 belongs to Jewish Community Free Clinic in Santa Rosa, CA.
Certificate of Waiver, effective September 13, 2026, expires September 12, 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
- September 13, 2026
- Certificate expiration
- September 12, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 1, 2001
- Facility type
- Community clinic
- Ownership (control type)
- Private
- 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
- 05D0989667
- Lab name
- Jewish Community Free Clinic
- Additional name
- Lions Clubhouse La Plaza Park, Parking
- Address
- 50 Montgomery Dr, Santa Rosa, CA 95404
- Phone
- (707) 585-7780
- Fax
- (707) 585-7784
Annual test volume the lab reported
- Waived tests
- 150
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 Jewish Community Free Clinic in Santa Rosa?
05D0989667, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Jewish Community Free Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D0989667 expire?
The CMS file lists September 12, 2028 as the certificate expiration date; the certificate took effect September 13, 2026.