CLIA lab
CLIA 05D2069163: Scpmg Palm Court I Medical Offices
Fontana, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2069163 belongs to Scpmg Palm Court I Medical Offices in Fontana, CA.
Certificate of Waiver, effective November 19, 2025, expires November 18, 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
- November 19, 2025
- Certificate expiration
- November 18, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 19, 2013
- Facility type
- Health maintenance organization
- 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
- 05D2069163
- Lab name
- Scpmg Palm Court I Medical Offices
- Address
- 17296 Slover Ave, Fontana, CA 92335
- Phone
- (909) 278-9012
- Fax
- (818) 503-6532
Annual test volume the lab reported
- Waived tests
- 10
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 Scpmg Palm Court I Medical Offices in Fontana?
05D2069163, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Scpmg Palm Court I Medical Offices hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2069163 expire?
The CMS file lists November 18, 2027 as the certificate expiration date; the certificate took effect November 19, 2025.