CLIA lab
CLIA 05D2170910: Bautista Medical Group Southern
Fillmore, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2170910 belongs to Bautista Medical Group Southern in Fillmore, 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
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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
- Physician office
- Ownership (control type)
- Proprietary
- 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
- 05D2170910
- Lab name
- Bautista Medical Group Southern
- Additional name
- California Inc
- Address
- 427 Central Avenue, Fillmore, CA 93015
- Phone
- (805) 524-2559
- Fax
- (805) 524-2596
Annual test volume the lab reported
- Waived tests
- 1,300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Fillmore, CA
- Fillmore Medical CenterCertificate for Provider-Performed Microscopy Procedures, Community clinic05D0929612
- Greenfield Care Center of Fillmore, LLCCertificate of Waiver, Skilled nursing or nursing facility05D2082422
- Mikael Hakansson MDCertificate for Provider-Performed Microscopy Procedures, Physician office05D1081420
- Rural Haven HomeCertificate of Waiver, Intermediate care facility for individuals with intellectual disabilities05D1080121
- Winter Haven HomeCertificate of Waiver, Intermediate care facility for individuals with intellectual disabilities05D1080645
Related
Questions
What is the CLIA number for Bautista Medical Group Southern in Fillmore?
05D2170910, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Bautista Medical Group Southern hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2170910 expire?
The CMS file lists August 20, 2027 as the certificate expiration date; the certificate took effect August 21, 2025.