CLIA lab

CLIA 05D2295580: Tristate Community Healthcare Center

Pomona, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.

CLIA number 05D2295580 belongs to Tristate Community Healthcare Center in Pomona, CA.

Certificate of Waiver, effective December 13, 2025, expires December 12, 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
December 13, 2025
Certificate expiration
December 12, 2027
Status in the CMS file
Active (termination code 00)
Original participation date
December 13, 2023
Facility type
Federally qualified health center
Ownership (control type)
Other
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
05D2295580
Lab name
Tristate Community Healthcare Center
Address
1532 San Bernadino Ave Suite A2, Pomona, CA 91767
Phone
(909) 301-4041
Fax
(909) 301-4042

Annual test volume the lab reported

Waived tests
9,000

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 Tristate Community Healthcare Center in Pomona?

05D2295580, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Tristate Community Healthcare Center hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 05D2295580 expire?

The CMS file lists December 12, 2027 as the certificate expiration date; the certificate took effect December 13, 2025.

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