CLIA lab
CLIA 05D1057492: ST Jude Heritage Health Foundation
Fullerton, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1057492 belongs to ST Jude Heritage Health Foundation in Fullerton, CA.
Certificate of Waiver, effective May 27, 2025, expires May 26, 2027.
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
- May 27, 2025
- Certificate expiration
- May 26, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 14, 2006
- Facility type
- Physician office
- Ownership (control type)
- Religious affiliation
- 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
- 05D1057492
- Lab name
- ST Jude Heritage Health Foundation
- Additional name
- Coumadin Clinic
- Address
- 100 E Valencia Mesa Dr Ste 206, Fullerton, CA 92835
- Phone
- (714) 446-5217
- Fax
- (714) 446-5613
Annual test volume the lab reported
- Waived tests
- 18,200
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 ST Jude Heritage Health Foundation in Fullerton?
05D1057492, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does ST Jude Heritage Health Foundation hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1057492 expire?
The CMS file lists May 26, 2027 as the certificate expiration date; the certificate took effect May 27, 2025.