CLIA lab
CLIA 05D1094950: Prime Pain Medicine Institute
Capitola, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1094950 belongs to Prime Pain Medicine Institute in Capitola, 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
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
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
- January 29, 2009
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- 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
- 05D1094950
- Lab name
- Prime Pain Medicine Institute
- Address
- 4140 Jade St Suite 102, Capitola, CA 95010
- Phone
- (831) 464-7246
- Fax
- (831) 576-2016
Annual test volume the lab reported
- Waived tests
- 100
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Capitola, CA
- Bayview Gastroenterology Medical CorpCertificate of Waiver, Physician office05D0989660
- Capitola Surgery CenterCertificate of Waiver, Ambulatory surgery center05D2051707
- Continuum Care Hospice LLCCertificate of Waiver, Hospice05D2240617
- Dignity Health Medical FoundationCertificate for Provider-Performed Microscopy Procedures, Physician office05D0918073
- Dignity Health Medical FoundationCertificate for Provider-Performed Microscopy Procedures, Physician office05D0918074
- Dignity Health Medical FoundationCertificate for Provider-Performed Microscopy Procedures, Physician office05D2089491
- Longs Drug Stores California, LLCCertificate of Waiver, Pharmacy05D2269055
- Odyssey Healthcare Operating A, LPCertificate of Waiver, Hospice05D2173055
- Pacific Coast ManorCertificate of Waiver, Skilled nursing or nursing facility05D0605433
- Packard Children's Health AllianceCertificate for Provider-Performed Microscopy Procedures, Physician office05D2078661
Related
Questions
What is the CLIA number for Prime Pain Medicine Institute in Capitola?
05D1094950, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Prime Pain Medicine Institute hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1094950 expire?
The CMS file lists January 28, 2027 as the certificate expiration date; the certificate took effect January 29, 2025.