CLIA lab
CLIA 05D2029739: Tatyana V. Borodulin, MD, Inc.
Campbell, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2029739 belongs to Tatyana V. Borodulin, MD, Inc. in Campbell, CA.
Certificate of Waiver, effective September 14, 2025, expires September 13, 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
- September 14, 2025
- Certificate expiration
- September 13, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 14, 2011
- 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
- 05D2029739
- Lab name
- Tatyana V. Borodulin, MD, Inc.
- Address
- 1600 W. Campbell Avenue, Suite 202, Campbell, CA 95008
- Phone
- (408) 378-3300
- Fax
- (408) 378-6822
Annual test volume the lab reported
- Waived tests
- 260
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Campbell, CA
- Alpine Lake Holdings LLC DBA Baywood Post-AcuteCertificate of Waiver, Skilled nursing or nursing facility05D0605389
- Aradhana Kar, MDCertificate of Waiver, Physician office05D0685857
- Bayhealth IncCertificate of Waiver, Home health agency05D2056706
- Calpath Medical AssociatesCertificate of Compliance, Independent05D0858234
- Campbell Surgery CenterCertificate of Waiver, Ambulatory surgery center05D2091236
- Carbon Health Medical Group of California,Certificate of Waiver, Physician office05D2192520
- Cep America - CaliforniaCertificate for Provider-Performed Microscopy Procedures, Physician office05D0894313
- Children's Recovery Center LaboratoryCertificate of Waiver, Hospital05D0932970
- Family Medicine Associates CampbellCertificate of Waiver, Physician office05D0606137
- Hill Vascular and Vein CenterCertificate of Waiver, Other05D2213048
Related
Questions
What is the CLIA number for Tatyana V. Borodulin, MD, Inc. in Campbell?
05D2029739, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Tatyana V. Borodulin, MD, Inc. hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2029739 expire?
The CMS file lists September 13, 2027 as the certificate expiration date; the certificate took effect September 14, 2025.