CLIA lab
CLIA 05D2276588: Providence Medical Foundation
San Clemente, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2276588 belongs to Providence Medical Foundation in San Clemente, CA.
Certificate of Waiver, effective February 10, 2025, expires February 9, 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
- February 10, 2025
- Certificate expiration
- February 9, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 10, 2023
- Facility type
- Physician office
- Ownership (control type)
- Religious affiliation
- 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
- 05D2276588
- Lab name
- Providence Medical Foundation
- Address
- 831 Via Suerte Suite 102, San Clemente, CA 92673
- Phone
- (949) 364-5600
- Fax
- (949) 364-2231
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.
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- Green Dermatologic Medical GroupCertificate of Compliance, Physician office05D0934428
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- Hoag ClinicCertificate of Waiver, Physician office05D2193830
- Hoag ClinicCertificate of Waiver, Physician office05D2302464
Related
Questions
What is the CLIA number for Providence Medical Foundation in San Clemente?
05D2276588, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Providence Medical Foundation hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2276588 expire?
The CMS file lists February 9, 2027 as the certificate expiration date; the certificate took effect February 10, 2025.