CLIA lab
CLIA 05D1030512: Foothill Surgical Institute
Lake Forest, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1030512 belongs to Foothill Surgical Institute in Lake Forest, 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
- 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
- 05D1030512
- Lab name
- Foothill Surgical Institute
- Address
- 29300 Portola Parkway Ste A, Lake Forest, CA 92630
- Phone
- (949) 484-7222
- Fax
- (949) 612-0857
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.
Other labs in Lake Forest, CA
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- A Better Life Recovery, LLCCertificate of Waiver, Other05D2275646
- A Better Life Recovery, LLCCertificate of Waiver, Other05D2285278
- Adel A Boutros, MDCertificate of Waiver, Physician office05D0897771
- Alcon LaboratoriesCertificate of Waiver, Other05D2279166
- Coastline EndocrinologyCertificate of Waiver, Physician office05D2338903
- Concentra Lake ForestCertificate of Waiver, Physician office05D0958933
- Foothill Gateway Surgery Center LLCCertificate of Waiver, Ambulatory surgery center05D1024936
- Freedom Village Health Care CenterCertificate of Waiver, Skilled nursing or nursing facility05D0880891
- Genomic Testing CooperativeCertificate of Accreditation, Independent05D2111917
Related
Questions
What is the CLIA number for Foothill Surgical Institute in Lake Forest?
05D1030512, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Foothill Surgical Institute hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1030512 expire?
The CMS file lists September 7, 2028 as the certificate expiration date; the certificate took effect September 8, 2026.