CLIA lab
CLIA 05D1098803: Valeria I Kozak, MD
Tustin, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D1098803 belongs to Valeria I Kozak, MD in Tustin, CA.
Certificate of Waiver, effective April 28, 2025, expires April 27, 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
- April 28, 2025
- Certificate expiration
- April 27, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 28, 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
- 05D1098803
- Lab name
- Valeria I Kozak, MD
- Address
- 17400 Irvine Blvd #j, Tustin, CA 92780
- Phone
- (714) 838-0022
- Fax
- (714) 838-0060
Annual test volume the lab reported
- Waived tests
- 626
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Valeria I Kozak, MD in Tustin?
05D1098803, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Valeria I Kozak, MD hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D1098803 expire?
The CMS file lists April 27, 2027 as the certificate expiration date; the certificate took effect April 28, 2025.