CLIA lab
CLIA 05D2104477: Optum Medical Services of California, P.C.
Covina, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2104477 belongs to Optum Medical Services of California, P.C. in Covina, CA.
Certificate of Waiver, effective November 5, 2025, expires November 4, 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 5, 2025
- Certificate expiration
- November 4, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 5, 2015
- Facility type
- Other practitioner
- 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
- 05D2104477
- Lab name
- Optum Medical Services of California, P.C.
- Address
- 420 W Rowland St, Covina, CA 91723
- Phone
- (952) 205-0628
Annual test volume the lab reported
- Waived tests
- 50,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Altamed Pace-CovinaCertificate of Waiver, Federally qualified health center05D2079964
- Angel Hospice Care, IncCertificate of Waiver, Hospice05D2151764
- Assissted Home Care IncCertificate of Waiver, Hospice05D2163025
- Assisted Home Recovery, IncCertificate of Waiver, Home health agency05D2310586
- Aurora Behavioral Hlth Care/CharterCertificate of Waiver, Hospital05D0873217
- Blanco Family MedicineCertificate of Waiver, Physician office05D2079424
- Boston Dermatology CorporationCertificate of Compliance, Physician office05D1003494
- Bradbourne Healthcare IncCertificate of Waiver, Home health agency05D1008691
- California Kidney SpecialistsCertificate of Waiver, Physician office05D0909741
Related
Questions
What is the CLIA number for Optum Medical Services of California, P.C. in Covina?
05D2104477, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Optum Medical Services of California, P.C. hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2104477 expire?
The CMS file lists November 4, 2027 as the certificate expiration date; the certificate took effect November 5, 2025.