CLIA lab
CLIA 05D1097025: Montecristo Medical PC
Van Nuys, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1097025 belongs to Montecristo Medical PC in Van Nuys, CA.
Certificate of Waiver, effective March 17, 2025, expires March 16, 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
- March 17, 2025
- Certificate expiration
- March 16, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- March 17, 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
- 05D1097025
- Lab name
- Montecristo Medical PC
- Address
- 14649 Victory Blvd Suite 20, Van Nuys, CA 91401
- Phone
- (818) 786-8396
- Fax
- (818) 901-7128
Annual test volume the lab reported
- Waived tests
- 350
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- A S H C Hospice Care IncCertificate of Waiver, Hospice05D2213279
- A&l Medical Center, IncCertificate of Waiver, Physician office05D2343005
- A-Biz Health Systems IncCertificate of Waiver, Home health agency05D2095744
- Advanced Quality Home Care IncCertificate of Waiver, Home health agency05D2303017
- Ae Urgent Care - Van NuysCertificate of Waiver, Physician office05D2289272
- Age Home Health CareCertificate of Waiver, Home health agency05D2343365
- All Inclusive Home CareCertificate of Waiver, Home health agency05D2292890
- All Linked Home Health, IncCertificate of Waiver, Home health agency05D2112938
- All in One Hospice Care IncCertificate of Waiver, Hospice05D2023717
Related
Questions
What is the CLIA number for Montecristo Medical PC in Van Nuys?
05D1097025, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Montecristo Medical PC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1097025 expire?
The CMS file lists March 16, 2027 as the certificate expiration date; the certificate took effect March 17, 2025.