CLIA lab
CLIA 05D1094983: Luther Mangoba MD Inc
Riverside, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1094983 belongs to Luther Mangoba MD Inc in Riverside, CA.
Certificate of Waiver, effective January 30, 2025, expires January 29, 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 30, 2025
- Certificate expiration
- January 29, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 30, 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
- 05D1094983
- Lab name
- Luther Mangoba MD Inc
- Address
- 9041 Magnolia Ave Ste 008, Riverside, CA 92503
- Phone
- (951) 687-0004
- Fax
- (951) 687-0080
Annual test volume the lab reported
- Waived tests
- 200
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- A-Quest Health Care IncCertificate of Waiver, Home health agency05D2043489
- Advance Care Services Inc, DBA Care Plus PharmacyCertificate of Waiver, Pharmacy05D2265041
- Afc Urgent Care RiversideCertificate of Accreditation, Other practitioner05D2095320
- Affinity Home Health Services, IncCertificate of Waiver, Home health agency05D1070005
- Agile Occupational Medicine, PCCertificate of Waiver, Physician office05D2331790
- Akeso Occupational Health - RiversideCertificate of Waiver, Physician office05D2314046
- Alta Vista Healthcare and Wellness CentreCertificate of Waiver, Skilled nursing or nursing facility05D0575422
Related
Questions
What is the CLIA number for Luther Mangoba MD Inc in Riverside?
05D1094983, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Luther Mangoba MD Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1094983 expire?
The CMS file lists January 29, 2027 as the certificate expiration date; the certificate took effect January 30, 2025.