CLIA lab
CLIA 05D2107941: Montebello Derm
Montebello, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2107941 belongs to Montebello Derm in Montebello, CA.
Certificate of Compliance, effective August 22, 2022, expires October 31, 2026.
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
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Compliance
- Certificate effective
- August 22, 2022
- Certificate expiration
- October 31, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 26, 2016
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 1
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D2107941
- Lab name
- Montebello Derm
- Address
- 2601 Via Campo Suite B, Montebello, CA 90640
- Phone
- (562) 988-7027
- Fax
- (562) 988-7400
Annual test volume the lab reported
- Other nonwaived tests
- 120
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Montebello, CA
- A Shawn Adhami MD A Professional CorpCertificate of Waiver, Physician office05D1033024
- Adventist Health White MemorialCertificate of Accreditation, Hospital05D0552242
- Adventist Health White MemorialCertificate of Waiver, Hospital05D0925580
- Adventist Health White Memorial Montebello CenterCertificate of Waiver, Other05D2313057
- Arbelos1 LLCCertificate of Accreditation, Independent05D2309204
- Art Vascular & Intervention Associates, IncCertificate of Waiver, Physician office05D2333140
- Atlantis Surgery Center MontebelloCertificate of Waiver, Ambulatory surgery center05D1097693
- Bertha A Gonzalez DO IncCertificate of Waiver, Physician office05D0955422
- Beverly Pediatric Medical Group IncCertificate of Waiver, Physician office05D0894885
- BeverlycareCertificate for Provider-Performed Microscopy Procedures, Federally qualified health center05D2054780
Related
Questions
What is the CLIA number for Montebello Derm in Montebello?
05D2107941, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Montebello Derm hold?
A Certificate of Compliance, according to the CMS file.
When does CLIA 05D2107941 expire?
The CMS file lists October 31, 2026 as the certificate expiration date; the certificate took effect August 22, 2022.