CLIA lab
CLIA 05D1077461: Permanente Medical Group Inc Mob-5,the
Santa Rosa, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1077461 belongs to Permanente Medical Group Inc Mob-5,the in Santa Rosa, CA.
Certificate of Waiver, effective December 11, 2025, expires December 10, 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
- December 11, 2025
- Certificate expiration
- December 10, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- December 11, 2007
- 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
- 05D1077461
- Lab name
- Permanente Medical Group Inc Mob-5,the
- Address
- 3975 Old Redwood Highway, Santa Rosa, CA 95403
- Phone
- (707) 393-4575
- Fax
- (707) 571-4390
Annual test volume the lab reported
- Waived tests
- 1,000
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
- 151 Sotoyme Hospital DBACertificate of Waiver, Hospital05D2135659
- 4th Street Laser & Surgery CenterCertificate of Waiver, Ambulatory surgery center05D1008140
- Advanced Home Health Northbay, IncCertificate of Waiver, Home health agency05D2068496
- Anjani Thakur , MD. Inc.Certificate of Waiver, Physician office05D2278394
- Arbol Healthcare Center of Santa RosaCertificate of Waiver, Skilled nursing or nursing facility05D0985872
- ArtemedicaCertificate of Waiver, Physician office05D2030692
- Aurora Behavioral HealthcareCertificate of Waiver, Other05D2053033
- Bennett Valley ICF DD H IncCertificate of Waiver, Intermediate care facility for individuals with intellectual disabilities05D0998299
- Bridges Pregnancy ClinicCertificate of Waiver, Community clinic05D0978274
- Brookdale ChanateCertificate of Waiver, Assisted living facility05D2215559
Related
Questions
What is the CLIA number for Permanente Medical Group Inc Mob-5,the in Santa Rosa?
05D1077461, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Permanente Medical Group Inc Mob-5,the hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1077461 expire?
The CMS file lists December 10, 2027 as the certificate expiration date; the certificate took effect December 11, 2025.