CLIA lab

CLIA 05D2035089: Adventist Health Lodi Memorial

Lodi, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.

CLIA number 05D2035089 belongs to Adventist Health Lodi Memorial in Lodi, CA.

Certificate of Waiver, effective January 10, 2026, expires January 9, 2028.

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 10, 2026
Certificate expiration
January 9, 2028
Status in the CMS file
Active (termination code 00)
Original participation date
January 10, 2012
Facility type
Physician office
Ownership (control type)
Religious affiliation
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
05D2035089
Lab name
Adventist Health Lodi Memorial
Address
2415 W Vine St Ste 106, Lodi, CA 95242
Phone
(209) 339-7411
Fax
(209) 333-3161

Annual test volume the lab reported

Waived tests
120

Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.

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Questions

What is the CLIA number for Adventist Health Lodi Memorial in Lodi?

05D2035089, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Adventist Health Lodi Memorial hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 05D2035089 expire?

The CMS file lists January 9, 2028 as the certificate expiration date; the certificate took effect January 10, 2026.

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