CLIA lab

CLIA 05D2296242: Providence Medical Institute

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

CLIA number 05D2296242 belongs to Providence Medical Institute in Redondo Beach, CA.

Certificate of Waiver, effective December 22, 2025, expires December 21, 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 22, 2025
Certificate expiration
December 21, 2027
Status in the CMS file
Active (termination code 00)
Original participation date
December 22, 2023
Facility type
Physician office
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
05D2296242
Lab name
Providence Medical Institute
Address
520 N Prospect Ave Suite 204, Redondo Beach, CA 90277
Phone
(310) 376-8816
Fax
(424) 212-5984

Annual test volume the lab reported

Waived tests
100

Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.

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Questions

What is the CLIA number for Providence Medical Institute in Redondo Beach?

05D2296242, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Providence Medical Institute hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 05D2296242 expire?

The CMS file lists December 21, 2027 as the certificate expiration date; the certificate took effect December 22, 2025.

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