CLIA lab
CLIA 05D1014120: Boulevard Pediatrics Medical Group, Inc
Encino, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1014120 belongs to Boulevard Pediatrics Medical Group, Inc in Encino, CA.
Certificate of Waiver, effective June 26, 2025, expires June 25, 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
- June 26, 2025
- Certificate expiration
- June 25, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 26, 2003
- 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
- 05D1014120
- Lab name
- Boulevard Pediatrics Medical Group, Inc
- Address
- 16550 Ventura Blvd Suite 414, Encino, CA 91436
- Phone
- (818) 783-3110
- Fax
- (818) 783-3115
Annual test volume the lab reported
- Waived tests
- 7,900
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Art Home Health Care IncCertificate of Waiver, Home health agency05D1077570
Related
Questions
What is the CLIA number for Boulevard Pediatrics Medical Group, Inc in Encino?
05D1014120, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Boulevard Pediatrics Medical Group, Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1014120 expire?
The CMS file lists June 25, 2027 as the certificate expiration date; the certificate took effect June 26, 2025.