CLIA lab
CLIA 05D1092277: Adventist Health Outpatient Pavilion
Ukiah, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1092277 belongs to Adventist Health Outpatient Pavilion in Ukiah, CA.
Certificate of Waiver, effective November 20, 2024, expires November 19, 2026.
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
- November 20, 2024
- Certificate expiration
- November 19, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 20, 2008
- Facility type
- Ambulatory surgery center
- Ownership (control type)
- Religious affiliation
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 4
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D1092277
- Lab name
- Adventist Health Outpatient Pavilion
- Address
- 245 Hospital Drive, Ukiah, CA 95482
- Phone
- (707) 463-7307
- Fax
- (707) 462-2306
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 Ukiah, CA
- Adventist Health Ukiah ValleyCertificate of Accreditation, Hospital05D0063759
- Adventist Health Ukiah ValleyCertificate for Provider-Performed Microscopy Procedures, Rural health clinic05D0612511
- Adventist Health Ukiah ValleyCertificate of Accreditation, Hospital05D0612598
- Adventist Health Ukiah ValleyCertificate for Provider-Performed Microscopy Procedures, Rural health clinic05D1100561
- Adventist Health Ukiah ValleyCertificate of Waiver, Other05D2295148
- Ahpn-Primary CareCertificate of Waiver, Physician office05D2346624
- Dialysis Clinic, Inc. - UkiahCertificate of Waiver, End stage renal disease dialysis facility05D2027538
- Mcavhn Care and Prevention NetworkCertificate of Waiver, Independent05D2094903
- Medical Offices of Robert Rushton, IncCertificate for Provider-Performed Microscopy Procedures, Rural health clinic05D0712957
- Medstar Ambulance of Mendocino County IncCertificate of Waiver, Ambulance05D2064253
Related
Questions
What is the CLIA number for Adventist Health Outpatient Pavilion in Ukiah?
05D1092277, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Adventist Health Outpatient Pavilion hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1092277 expire?
The CMS file lists November 19, 2026 as the certificate expiration date; the certificate took effect November 20, 2024.