CLIA lab
CLIA 05D2170576: Wesley Health Centers Vermont Annex
Los Angeles, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2170576 belongs to Wesley Health Centers Vermont Annex in Los Angeles, CA.
Certificate of Waiver, effective August 14, 2025, expires August 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
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 Waiver
- Certificate effective
- August 14, 2025
- Certificate expiration
- August 13, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 14, 2019
- Facility type
- Federally qualified health center
- Ownership (control type)
- Private
- 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
- 05D2170576
- Lab name
- Wesley Health Centers Vermont Annex
- Address
- 964 Vermont Avenue, Los Angeles, CA 90029
- Phone
- (323) 201-4516
- Fax
- (323) 215-0170
Annual test volume the lab reported
- Waived tests
- 1,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Los Angeles, CA
- 1 Method CenterCertificate of Waiver, Other05D2122141
- 1 Method CenterCertificate of Waiver, Ancillary test site05D2222235
- 1 Method CorpCertificate of Waiver, Other05D2227773
- 1 Method CorpCertificate of Waiver, Other05D2295974
- 10X Health Ventures, LLCCertificate of Waiver, Other05D2314925
- 1741 Hauser Blvd Detox LLCCertificate of Waiver, Other05D2292193
- 2080 Century Park LaboratoryCertificate of Compliance, Independent05D0669071
- 2nd Century Adult Day Hlth Care IncCertificate of Waiver, Other05D0984182
- 2nd Home Adult Health Care IncCertificate of Waiver, Other05D2344147
- 300 S Robertson Dialysis, LLCCertificate of Waiver, End stage renal disease dialysis facility05D0962071
Related
Questions
What is the CLIA number for Wesley Health Centers Vermont Annex in Los Angeles?
05D2170576, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Wesley Health Centers Vermont Annex hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2170576 expire?
The CMS file lists August 13, 2027 as the certificate expiration date; the certificate took effect August 14, 2025.