CLIA lab
CLIA 05D2172872: Scpmg Menifee Target
Menifee, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2172872 belongs to Scpmg Menifee Target in Menifee, CA.
Certificate of Waiver, effective October 1, 2025, expires September 30, 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
- October 1, 2025
- Certificate expiration
- September 30, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 1, 2019
- Facility type
- Health maintenance organization
- 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
- 05D2172872
- Lab name
- Scpmg Menifee Target
- Address
- 30340 Haun Road, Menifee, CA 92584
- Phone
- (818) 503-6654
- Fax
- (818) 503-6532
Annual test volume the lab reported
- Waived tests
- 6,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Abayomi A Odubela MD ACertificate of Waiver, Physician office05D1000089
- Advanced Dermatology, Thomas J Hoffmann MDCertificate of Compliance, Physician office05D1057914
- Brightstar CareCertificate of Waiver, Home health agency05D2065998
- CV Mehta MD Medical CorpCertificate of Waiver, Physician office05D2293807
- Children's Primary Care Medical GroupCertificate of Waiver, Physician office05D0988912
- Gonzales Medical GroupCertificate of Waiver, Physician office05D0951428
- Grace Family Health, Inc.Certificate of Waiver, Physician office05D2291137
- Menifee Dental GroupCertificate of Waiver, Other05D2287683
- Menifee Global Multi-Specialty Group IncCertificate of Waiver, Physician office05D2282664
Related
Questions
What is the CLIA number for Scpmg Menifee Target in Menifee?
05D2172872, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Scpmg Menifee Target hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2172872 expire?
The CMS file lists September 30, 2027 as the certificate expiration date; the certificate took effect October 1, 2025.