CLIA lab
CLIA 05D2066722: Sky Lake Recovery Center, LLC
South Lake Tahoe, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2066722 belongs to Sky Lake Recovery Center, LLC in South Lake Tahoe, CA.
Certificate of Waiver, effective October 2, 2025, expires October 1, 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
- October 2, 2025
- Certificate expiration
- October 1, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 2, 2013
- Facility type
- Other
- 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
- 05D2066722
- Lab name
- Sky Lake Recovery Center, LLC
- Address
- 586 Glorene Avenue, C/o Mason Ungar, South Lake Tahoe, CA 96150
- Phone
- (831) 740-4639
- Fax
- (831) 768-8573
Annual test volume the lab reported
- Waived tests
- 1,000
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 Sky Lake Recovery Center, LLC in South Lake Tahoe?
05D2066722, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Sky Lake Recovery Center, LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2066722 expire?
The CMS file lists October 1, 2027 as the certificate expiration date; the certificate took effect October 2, 2025.