CLIA lab
CLIA 05D2143782: Providence TMC ST Jude
Fullerton, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2143782 belongs to Providence TMC ST Jude in Fullerton, CA.
Certificate of Waiver, effective July 8, 2025, expires July 7, 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 8, 2025
- Certificate expiration
- July 7, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 5, 2018
- Facility type
- Physician office
- Ownership (control type)
- Religious affiliation
- 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
- 05D2143782
- Lab name
- Providence TMC ST Jude
- Address
- 1950 Sunny Crest Dr, Ste 2600, Fullerton, CA 92835
- Phone
- (714) 446-5590
- Fax
- (714) 446-5592
Annual test volume the lab reported
- Waived tests
- 2,000
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 Providence TMC ST Jude in Fullerton?
05D2143782, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Providence TMC ST Jude hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2143782 expire?
The CMS file lists July 7, 2027 as the certificate expiration date; the certificate took effect July 8, 2025.