CLIA lab
CLIA 05D1008140: 4th Street Laser & Surgery Center
Santa Rosa, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1008140 belongs to 4th Street Laser & Surgery Center in Santa Rosa, CA.
Certificate of Waiver, effective January 10, 2025, expires January 9, 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
- January 10, 2025
- Certificate expiration
- January 9, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 10, 2003
- Facility type
- Ambulatory surgery center
- 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
- 05D1008140
- Lab name
- 4th Street Laser & Surgery Center
- Address
- 1720 Fourth Street, Santa Rosa, CA 95404
- Phone
- (707) 708-2808
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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- Anjani Thakur , MD. Inc.Certificate of Waiver, Physician office05D2278394
- Arbol Healthcare Center of Santa RosaCertificate of Waiver, Skilled nursing or nursing facility05D0985872
- ArtemedicaCertificate of Waiver, Physician office05D2030692
- Aurora Behavioral HealthcareCertificate of Waiver, Other05D2053033
- Bennett Valley ICF DD H IncCertificate of Waiver, Intermediate care facility for individuals with intellectual disabilities05D0998299
- Bridges Pregnancy ClinicCertificate of Waiver, Community clinic05D0978274
- Brookdale ChanateCertificate of Waiver, Assisted living facility05D2215559
- Brookdale Paulin CreekCertificate of Waiver, Assisted living facility05D2215451
Related
Questions
What is the CLIA number for 4th Street Laser & Surgery Center in Santa Rosa?
05D1008140, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does 4th Street Laser & Surgery Center hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1008140 expire?
The CMS file lists January 9, 2027 as the certificate expiration date; the certificate took effect January 10, 2025.