CLIA lab
CLIA 05D2096010: Coffee Road Surgery Center LLC
Modesto, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2096010 belongs to Coffee Road Surgery Center LLC in Modesto, CA.
Certificate of Waiver, effective May 14, 2025, expires May 13, 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
- May 14, 2025
- Certificate expiration
- May 13, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 14, 2015
- Facility type
- Ambulatory surgery center
- 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
- 05D2096010
- Lab name
- Coffee Road Surgery Center LLC
- Address
- 1335 Coffee Rd Ste 201, Modesto, CA 95355
- Phone
- (209) 360-2582
- Fax
- (209) 859-6001
Annual test volume the lab reported
- Waived tests
- 1,500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Almond Vista HealthcareCertificate of Waiver, Skilled nursing or nursing facility05D0726157
Related
Questions
What is the CLIA number for Coffee Road Surgery Center LLC in Modesto?
05D2096010, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Coffee Road Surgery Center LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2096010 expire?
The CMS file lists May 13, 2027 as the certificate expiration date; the certificate took effect May 14, 2025.