CLIA lab
CLIA 05D2133672: Providence Medical Institute
Hawthorne, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2133672 belongs to Providence Medical Institute in Hawthorne, CA.
Certificate of Waiver, effective July 18, 2025, expires July 17, 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
- July 18, 2025
- Certificate expiration
- July 17, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- July 18, 2017
- Facility type
- Physician office
- Ownership (control type)
- Other
- 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
- 05D2133672
- Lab name
- Providence Medical Institute
- Address
- 12618 Hawthorne Blvd, Hawthorne, CA 90250
- Phone
- (310) 263-5700
- Fax
- (310) 263-5771
Annual test volume the lab reported
- Waived tests
- 3,500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Hawthorne, CA
- Ace Medical GroupCertificate of Waiver, Physician office05D0954191
- Acknowledge Home Health IncCertificate of Waiver, Home health agency05D1018472
- Ajay G Meka MD IncCertificate of Waiver, Physician office05D0693906
- Ali Awada, MD, IncCertificate of Waiver, Physician office05D1046690
- Ananias E Ebilane MDCertificate of Waiver, Physician office05D0547880
- Behavioral Health ServicesCertificate of Waiver, Federally qualified health center05D2110453
- Camino HealthcareCertificate of Waiver, Skilled nursing or nursing facility05D0885481
- Centro Medico IncCertificate of Waiver, Physician office05D0896728
- College Medical Center Hawthorne CampusCertificate of Waiver, Hospital05D2207151
- Continuity Providers Healthcare IncCertificate of Waiver, Home health agency05D2034849
Related
Questions
What is the CLIA number for Providence Medical Institute in Hawthorne?
05D2133672, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Providence Medical Institute hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2133672 expire?
The CMS file lists July 17, 2027 as the certificate expiration date; the certificate took effect July 18, 2025.