CLIA lab
CLIA 05D2290944: Ivy Park at Santa Rosa
Santa Rosa, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2290944 belongs to Ivy Park at Santa Rosa in Santa Rosa, CA.
Certificate of Waiver, effective October 3, 2025, expires October 2, 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
- October 3, 2025
- Certificate expiration
- October 2, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 3, 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
- 05D2290944
- Lab name
- Ivy Park at Santa Rosa
- Address
- 4225 Wayvern Drive, Santa Rosa, CA 95409
- Phone
- (530) 227-5738
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.
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- 4th Street Laser & Surgery CenterCertificate of Waiver, Ambulatory surgery center05D1008140
- Advanced Home Health Northbay, IncCertificate of Waiver, Home health agency05D2068496
- Anjani Thakur , MD. Inc.Certificate of Waiver, Physician office05D2278394
- Arbol Healthcare Center of Santa RosaCertificate of Waiver, Skilled nursing or nursing facility05D0985872
- ArtemedicaCertificate of Waiver, Physician office05D2030692
- Aurora Behavioral HealthcareCertificate of Waiver, Other05D2053033
- Bennett Valley ICF DD H IncCertificate of Waiver, Intermediate care facility for individuals with intellectual disabilities05D0998299
- Bridges Pregnancy ClinicCertificate of Waiver, Community clinic05D0978274
- Brookdale ChanateCertificate of Waiver, Assisted living facility05D2215559
Related
Questions
What is the CLIA number for Ivy Park at Santa Rosa in Santa Rosa?
05D2290944, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Ivy Park at Santa Rosa hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2290944 expire?
The CMS file lists October 2, 2027 as the certificate expiration date; the certificate took effect October 3, 2025.