CLIA lab
CLIA 05D2049491: Pine Grove Healthcare & Wellness Centre, LP
San Gabriel, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2049491 belongs to Pine Grove Healthcare & Wellness Centre, LP in San Gabriel, CA.
Certificate of Waiver, effective November 7, 2024, expires November 6, 2026.
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
- November 7, 2024
- Certificate expiration
- November 6, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 7, 2012
- Facility type
- Skilled nursing or nursing facility
- 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
- 05D2049491
- Lab name
- Pine Grove Healthcare & Wellness Centre, LP
- Address
- 126 N. San Gabriel Blvd., San Gabriel, CA 91775
- Phone
- (626) 285-3131
- Fax
- (626) 285-2391
Annual test volume the lab reported
- Waived tests
- 25,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Care facility at this address
- Pine Grove Healthcare & Wellness Centre, LPCMS Care Compare ratings for the facility at the same street address
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- Green Pine Home Health Care ServicesCertificate of Waiver, Home health agency05D1070324
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Questions
What is the CLIA number for Pine Grove Healthcare & Wellness Centre, LP in San Gabriel?
05D2049491, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Pine Grove Healthcare & Wellness Centre, LP hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2049491 expire?
The CMS file lists November 6, 2026 as the certificate expiration date; the certificate took effect November 7, 2024.