CLIA lab
CLIA 05D2288727: Ivy Park at San Juan Capistrano
San Juan Capistrano, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2288727 belongs to Ivy Park at San Juan Capistrano in San Juan Capistrano, CA.
Certificate of Waiver, effective August 29, 2025, expires August 28, 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
- August 29, 2025
- Certificate expiration
- August 28, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 29, 2023
- Facility type
- Assisted living facility
- 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
- 05D2288727
- Lab name
- Ivy Park at San Juan Capistrano
- Address
- 32200 Del Obispo Street, San Juan Capistrano, CA 92675
- Phone
- (530) 227-5738
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 Ivy Park at San Juan Capistrano in San Juan Capistrano?
05D2288727, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Ivy Park at San Juan Capistrano hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2288727 expire?
The CMS file lists August 28, 2027 as the certificate expiration date; the certificate took effect August 29, 2025.