CLIA lab

CLIA 05D1034114: Permanente Medical Group Inc Round Barn Lab, the

Santa Rosa, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.

CLIA number 05D1034114 belongs to Permanente Medical Group Inc Round Barn Lab, the in Santa Rosa, CA.

Certificate of Waiver, effective November 24, 2024, expires November 23, 2026.

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
November 24, 2024
Certificate expiration
November 23, 2026
Status in the CMS file
Active (termination code 00)
Original participation date
November 24, 2004
Facility type
Ancillary test site
Ownership (control type)
Private
Lab classification
CLIA laboratory
Directly affiliated labs
3

Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page

Lab and contact

CLIA number
05D1034114
Lab name
Permanente Medical Group Inc Round Barn Lab, the
Address
3559 Round Barn Blvd, Santa Rosa, CA 95403
Phone
(707) 393-3123
Fax
(707) 393-4390

Annual test volume the lab reported

Waived tests
17

Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.

Affiliated CLIA numbers

Other labs in Santa Rosa, CA

Related

Questions

What is the CLIA number for Permanente Medical Group Inc Round Barn Lab, the in Santa Rosa?

05D1034114, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Permanente Medical Group Inc Round Barn Lab, the hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 05D1034114 expire?

The CMS file lists November 23, 2026 as the certificate expiration date; the certificate took effect November 24, 2024.

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