CLIA lab
CLIA 05D1087167: Heritage Victor Valley Medical Group - Phelan
Phelan, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1087167 belongs to Heritage Victor Valley Medical Group - Phelan in Phelan, CA.
Certificate of Waiver, effective January 29, 2025, expires January 28, 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
- January 29, 2025
- Certificate expiration
- January 28, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- July 28, 2008
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 1
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D1087167
- Lab name
- Heritage Victor Valley Medical Group - Phelan
- Address
- 3936 Phelan Rd Suite F1, Phelan, CA 92371
- Phone
- (760) 868-6622
- Fax
- (760) 868-2505
Annual test volume the lab reported
- Waived tests
- 500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Phelan, CA
Related
Questions
What is the CLIA number for Heritage Victor Valley Medical Group - Phelan in Phelan?
05D1087167, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Heritage Victor Valley Medical Group - Phelan hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1087167 expire?
The CMS file lists January 28, 2027 as the certificate expiration date; the certificate took effect January 29, 2025.