CLIA lab
CLIA 05D2170609: Memorialcare Medical Group
Tustin, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2170609 belongs to Memorialcare Medical Group in Tustin, 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
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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
- Physician office
- 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
- 05D2170609
- Lab name
- Memorialcare Medical Group
- Address
- 17251-B 17th Street, Tustin, CA 92780
- Phone
- (657) 241-8580
- Fax
- (714) 665-4608
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.
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Related
Questions
What is the CLIA number for Memorialcare Medical Group in Tustin?
05D2170609, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Memorialcare Medical Group hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2170609 expire?
The CMS file lists August 13, 2027 as the certificate expiration date; the certificate took effect August 14, 2025.