CLIA lab
CLIA 05D1030502: Packard Children's Health Alliance
Tracy, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1030502 belongs to Packard Children's Health Alliance in Tracy, CA.
Certificate of Waiver, effective September 8, 2026, expires September 7, 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 8, 2026
- Certificate expiration
- September 7, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 8, 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
- 05D1030502
- Lab name
- Packard Children's Health Alliance
- Address
- 4598 South Tracy Blvd., Ste. 110, Tracy, CA 95377
- Phone
- (209) 839-1432
- Fax
- (209) 839-8681
Annual test volume the lab reported
- Waived tests
- 2,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Crisis Pregnancy Center of TracyCertificate of Waiver, Other05D1031050
- Delta Eye Medical Group, Inc.Certificate of Waiver, Physician office05D2060650
- Golden State DermatologyCertificate of Compliance, Physician office05D2228655
- Grant Line DialysisCertificate of Waiver, End stage renal disease dialysis facility05D2182931
- Great Valley Home Health LLCCertificate of Waiver, Home health agency05D2181717
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Related
Questions
What is the CLIA number for Packard Children's Health Alliance in Tracy?
05D1030502, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Packard Children's Health Alliance hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1030502 expire?
The CMS file lists September 7, 2028 as the certificate expiration date; the certificate took effect September 8, 2026.