CLIA lab
CLIA 05D2210233: Stacy Medical Center, Inc
Vernon, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2210233 belongs to Stacy Medical Center, Inc in Vernon, CA.
Certificate of Waiver, effective January 20, 2025, expires January 19, 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
- January 20, 2025
- Certificate expiration
- January 19, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- January 20, 2021
- Facility type
- Other practitioner
- 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
- 05D2210233
- Lab name
- Stacy Medical Center, Inc
- Address
- 4580 Pacific Blvd, Vernon, CA 90058
- Phone
- (323) 584-0779
- Fax
- (323) 584-2282
Annual test volume the lab reported
- Waived tests
- 2,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Vernon, CA
- Concentra Medical Centers - Vernon CentralCertificate of Waiver, Physician office05D2011117
- Concentra Medical Centers-Vernon SotoCertificate of Waiver, Physician office05D0903495
- La Urgent CareCertificate of Waiver, Physician office05D2108114
- Proactive Work Health ServicesCertificate of Waiver, Physician office05D2338342
- Universal Huntington Park DialysisCertificate of Waiver, End stage renal disease dialysis facility05D2176968
Related
Questions
What is the CLIA number for Stacy Medical Center, Inc in Vernon?
05D2210233, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Stacy Medical Center, Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2210233 expire?
The CMS file lists January 19, 2027 as the certificate expiration date; the certificate took effect January 20, 2025.