CLIA lab
CLIA 05D1050001: Sutter Gould Medical Foundation-
Lodi, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1050001 belongs to Sutter Gould Medical Foundation- in Lodi, CA.
Certificate for Provider-Performed Microscopy Procedures, 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 for Provider-Performed Microscopy Procedures
- Certificate effective
- January 23, 2026
- Certificate expiration
- January 22, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 23, 2006
- 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
- 05D1050001
- Lab name
- Sutter Gould Medical Foundation-
- Additional name
- Kettleman Care Center
- Address
- 1335 South Fairmont Avenue, Lodi, CA 95242
- Phone
- (209) 988-3294
- Fax
- (209) 366-2026
Annual test volume the lab reported
- Waived tests
- 2,500
- Provider-performed microscopy tests
- 110
- Total
- 2,610
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Lodi, CA
- Adventist Health Lodi MemorialCertificate of Accreditation, Hospital05D0609686
- Adventist Health Lodi MemorialCertificate of Waiver, Community clinic05D0862779
- Adventist Health Lodi MemorialCertificate of Waiver, Physician office05D0885857
- Adventist Health Lodi MemorialCertificate of Waiver, Physician office05D2035089
- Adventist Health Lodi MemorialCertificate of Waiver, Physician office05D2095753
- Adventist Health Physicians NetworkCertificate of Waiver, Physician office05D1097139
- Adventist Health Physicians NetworkCertificate of Waiver, Physician office05D2120316
- Adventist Health Physicians NetworkCertificate of Waiver, Physician office05D2341365
- Adventist Health Physicians Network - Cancer CareCertificate of Waiver, Physician office05D2212313
- Adventist Health Physicians Network - Lodi UrologyCertificate for Provider-Performed Microscopy Procedures, Physician office05D2154128
Related
Questions
What is the CLIA number for Sutter Gould Medical Foundation- in Lodi?
05D1050001, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Sutter Gould Medical Foundation- hold?
A Certificate for Provider-Performed Microscopy Procedures, according to the CMS file.
When does CLIA 05D1050001 expire?
The CMS file lists January 22, 2028 as the certificate expiration date; the certificate took effect January 23, 2026.