CLIA lab
CLIA 05D2193966: Jay N Gordon MD Faap
Santa Monica, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2193966 belongs to Jay N Gordon MD Faap in Santa Monica, CA.
Certificate of Waiver, effective September 25, 2024, expiration date September 24, 2026.
The CMS file posted October 16, 2026 lists the certificate as active, but its expiration date has passed. A renewal may not be in this file yet.
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
- September 25, 2024
- Certificate expiration
- September 24, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 25, 2020
- 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
- 05D2193966
- Lab name
- Jay N Gordon MD Faap
- Address
- 501 10th St, Santa Monica, CA 90402
- Phone
- (310) 393-9784
- Fax
- (310) 393-0187
Annual test volume the lab reported
- Waived tests
- 500
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 Jay N Gordon MD Faap in Santa Monica?
05D2193966, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Jay N Gordon MD Faap hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2193966 expire?
The CMS file lists September 24, 2026 as the certificate expiration date; the certificate took effect September 25, 2024.