CLIA lab
CLIA 05D2200588: ST. Grace Manor, Inc
Montclair, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2200588 belongs to ST. Grace Manor, Inc in Montclair, CA.
Certificate of Waiver, effective November 16, 2024, expires November 15, 2026.
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
- November 16, 2024
- Certificate expiration
- November 15, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- November 16, 2020
- Facility type
- Intermediate care facility for individuals with intellectual disabilities
- 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
- 05D2200588
- Lab name
- ST. Grace Manor, Inc
- Address
- 4440 Fauna Street, Montclair, CA 91763
- Phone
- (909) 577-0110
- Fax
- (909) 577-0111
Annual test volume the lab reported
- Waived tests
- 144
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Montclair, CA
- A Tu Salud A Medical CorpCertificate of Waiver, Physician office05D1063765
- Aces Home Healthcare Services IncCertificate of Waiver, Home health agency05D1060612
- Advanced Wellness Home Care IncCertificate of Waiver, Home health agency05D2165896
- Affective Hospice Care, IncCertificate of Waiver, Hospice05D2107459
- Angels on Earth HospiceCertificate of Waiver, Hospice05D2036471
- Benchmark Young Adult SchoolCertificate of Waiver, Ancillary test site05D2316028
- Benchmark at MonclairCertificate of Waiver, Ancillary test site05D2291219
- Best Serene Home Health IncCertificate of Waiver, Home health agency05D2304908
- Brightlane Healthcare IncCertificate of Waiver, Home health agency05D2230260
- California Professional CareCertificate of Waiver, Home health agency05D2216956
Related
Questions
What is the CLIA number for ST. Grace Manor, Inc in Montclair?
05D2200588, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does ST. Grace Manor, Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2200588 expire?
The CMS file lists November 15, 2026 as the certificate expiration date; the certificate took effect November 16, 2024.