CLIA lab
CLIA 05D1031204: Packard Children's Health Alliance
Los Gatos, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1031204 belongs to Packard Children's Health Alliance in Los Gatos, CA.
Certificate of Waiver, effective September 27, 2026, expires September 26, 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 27, 2026
- Certificate expiration
- September 26, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 27, 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
- 05D1031204
- Lab name
- Packard Children's Health Alliance
- Additional name
- DBA South Bascom Pediatrics
- Address
- 15899 Los Gatos Almaden Rd Ste 4, Los Gatos, CA 95032
- Phone
- (408) 356-7770
- Fax
- (408) 356-7774
Annual test volume the lab reported
- Waived tests
- 400
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Packard Children's Health Alliance in Los Gatos?
05D1031204, 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 05D1031204 expire?
The CMS file lists September 26, 2028 as the certificate expiration date; the certificate took effect September 27, 2026.