CLIA lab
CLIA 05D2065862: Adventist Health Konocti
Lower Lake, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2065862 belongs to Adventist Health Konocti in Lower Lake, CA.
Certificate of Waiver, effective March 17, 2026, expires March 16, 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
- March 17, 2026
- Certificate expiration
- March 16, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 16, 2013
- Facility type
- Rural health clinic
- Ownership (control type)
- Other
- 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
- 05D2065862
- Lab name
- Adventist Health Konocti
- Additional name
- Wellness Center
- Address
- 9340 Lake St Ste C, Lower Lake, CA 95457
- Phone
- (707) 995-5778
- Fax
- (707) 995-5816
Annual test volume the lab reported
- Waived tests
- 5,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Related
Questions
What is the CLIA number for Adventist Health Konocti in Lower Lake?
05D2065862, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Adventist Health Konocti hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2065862 expire?
The CMS file lists March 16, 2028 as the certificate expiration date; the certificate took effect March 17, 2026.