CLIA lab
CLIA 05D1072419: Pediatric Dental Initiative (Pdi) Surgery Center
Windsor, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1072419 belongs to Pediatric Dental Initiative (Pdi) Surgery Center in Windsor, CA.
Certificate of Waiver, effective August 16, 2025, expires August 15, 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
- August 16, 2025
- Certificate expiration
- August 15, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 16, 2007
- Facility type
- Ambulatory surgery center
- Ownership (control type)
- Other
- 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
- 05D1072419
- Lab name
- Pediatric Dental Initiative (Pdi) Surgery Center
- Address
- 1380 19th Hole Drive, Windsor, CA 95492
- Phone
- (707) 838-6560
- Fax
- (707) 838-8464
Annual test volume the lab reported
- Waived tests
- 1,500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Windsor, CA
- Alliance Medical Center - Windsor SiteCertificate of Waiver, Federally qualified health center05D2178256
- Brookdale WindsorCertificate of Waiver, Assisted living facility05D2212201
- Lakewood Recovery LLCCertificate of Waiver, Other05D2326490
- Providence Medical FoundationCertificate of Waiver, Physician office05D2096513
- Safeway Pharmacy #1434Certificate of Waiver, Pharmacy05D2059774
- Satellite Healthcare WindsorCertificate of Waiver, End stage renal disease dialysis facility05D1002707
- Walmart Pharmacy #10-2553Certificate of Waiver, Pharmacy05D2340696
Related
Questions
What is the CLIA number for Pediatric Dental Initiative (Pdi) Surgery Center in Windsor?
05D1072419, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Pediatric Dental Initiative (Pdi) Surgery Center hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1072419 expire?
The CMS file lists August 15, 2027 as the certificate expiration date; the certificate took effect August 16, 2025.