CLIA lab
CLIA 05D1021507: Bolivar Family Medical Clinic
Riverside, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1021507 belongs to Bolivar Family Medical Clinic in Riverside, CA.
Certificate of Waiver, effective January 23, 2026, expires January 22, 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
- January 23, 2026
- Certificate expiration
- January 22, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 23, 2004
- Facility type
- Physician office
- 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
- 05D1021507
- Lab name
- Bolivar Family Medical Clinic
- Address
- 10327 Hole Ave, Riverside, CA 92505
- Phone
- (909) 351-1600
- Fax
- (909) 351-9400
Annual test volume the lab reported
- Waived tests
- 900
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Afc Urgent Care RiversideCertificate of Accreditation, Other practitioner05D2095320
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Related
Questions
What is the CLIA number for Bolivar Family Medical Clinic in Riverside?
05D1021507, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Bolivar Family Medical Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1021507 expire?
The CMS file lists January 22, 2028 as the certificate expiration date; the certificate took effect January 23, 2026.