CLIA lab
CLIA 05D2219107: Innovative Compounding Inc
Folsom, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2219107 belongs to Innovative Compounding Inc in Folsom, CA.
Certificate of Waiver, effective April 1, 2025, expires March 31, 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
- April 1, 2025
- Certificate expiration
- March 31, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 1, 2021
- Facility type
- Pharmacy
- 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
- 05D2219107
- Lab name
- Innovative Compounding Inc
- Additional name
- DBA Innovative Compounding Pharmacy
- Address
- 820 Wales Dr, Folsom, CA 95630
- Phone
- (916) 984-9222
- Fax
- (916) 458-8267
Annual test volume the lab reported
- Waived tests
- 200
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Folsom, CA
- Advanced Pain Diagnostic & SolutionsCertificate of Waiver, Physician office05D2284359
- Bella Nirvana Center, IncCertificate of Waiver, Other05D2127809
- Bella Nirvana Center, IncCertificate of Waiver, Other05D2158821
- Bellestar Home Health Care IncCertificate of Waiver, Home health agency05D2148669
- Bingtao Lin MD PCCertificate of Waiver, Physician office05D2159882
- Brookdale FolsomCertificate of Waiver, Assisted living facility05D2215443
- Carbon Health Medical GroupCertificate of Waiver, Physician office05D1052037
- Creekside Internal Med/Sam Khouri MDCertificate of Waiver, Physician office05D0970677
- Dentists of FolsomCertificate of Waiver, Other practitioner05D2342946
- Dignity Health Medical FoundationCertificate for Provider-Performed Microscopy Procedures, Physician office05D1063141
Related
Questions
What is the CLIA number for Innovative Compounding Inc in Folsom?
05D2219107, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Innovative Compounding Inc hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2219107 expire?
The CMS file lists March 31, 2027 as the certificate expiration date; the certificate took effect April 1, 2025.