CLIA lab
CLIA 05D2302474: Irc-Sutter Health Jackson, LLC
Jackson, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2302474 belongs to Irc-Sutter Health Jackson, LLC in Jackson, CA.
Certificate of Waiver, effective April 10, 2026, expires April 9, 2028.
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
- April 10, 2026
- Certificate expiration
- April 9, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 10, 2024
- Facility type
- End stage renal disease dialysis 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
- 05D2302474
- Lab name
- Irc-Sutter Health Jackson, LLC
- Address
- 12030 Industry Blvd, Jackson, CA 95642
- Phone
- (209) 273-3060
- Fax
- (209) 273-3374
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.
Care facility at this address
- Innovative Renal Care JacksonCMS Care Compare ratings for the facility at the same street address
Other labs in Jackson, CA
- Amador Family Physicians Medical CorporationCertificate for Provider-Performed Microscopy Procedures, Physician office05D0984183
- Hospice of Amador & CalaverasCertificate of Waiver, Hospice05D0926617
- Jackson Rancheria Medical CenterCertificate of Waiver, Physician office05D2074377
- Kit Carson Nursing and RehabilitationCertificate of Waiver, Skilled nursing or nursing facility05D0725688
- Mact Dental, JacksonCertificate of Waiver, Ancillary test site05D2216008
- Mact Medical, JacksonCertificate for Provider-Performed Microscopy Procedures, Other05D0698999
- Safeway Pharmacy #2778Certificate of Waiver, Pharmacy05D2079747
- Sierra Eyecare AssociatesCertificate of Waiver, Other practitioner05D2173099
- Sutter Amador Surgery Center, LLCCertificate of Waiver, Ambulatory surgery center05D1036653
- Sutter-Amador Hospital LaboratoryCertificate of Accreditation, Hospital05D0063882
Related
Questions
What is the CLIA number for Irc-Sutter Health Jackson, LLC in Jackson?
05D2302474, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Irc-Sutter Health Jackson, LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2302474 expire?
The CMS file lists April 9, 2028 as the certificate expiration date; the certificate took effect April 10, 2026.