CLIA lab
CLIA 05D2170904: Cloverdale Health Care District -Ambulance
Cloverdale, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2170904 belongs to Cloverdale Health Care District -Ambulance in Cloverdale, CA.
Certificate of Waiver, effective August 21, 2025, expires August 20, 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 21, 2025
- Certificate expiration
- August 20, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 21, 2019
- Facility type
- Ambulance
- Ownership (control type)
- Government, 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
- 05D2170904
- Lab name
- Cloverdale Health Care District -Ambulance
- Address
- 209 North Main Street, Cloverdale, CA 95425
- Phone
- (707) 894-5862
- Fax
- (707) 894-9532
Annual test volume the lab reported
- Waived tests
- 600
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Cloverdale, CA
Related
Questions
What is the CLIA number for Cloverdale Health Care District -Ambulance in Cloverdale?
05D2170904, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Cloverdale Health Care District -Ambulance hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2170904 expire?
The CMS file lists August 20, 2027 as the certificate expiration date; the certificate took effect August 21, 2025.