CLIA lab
CLIA 05D2302968: Victory Bay Residential Services I, LLC
Tarzana, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2302968 belongs to Victory Bay Residential Services I, LLC in Tarzana, CA.
Certificate of Waiver, effective April 18, 2026, expires April 17, 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 18, 2026
- Certificate expiration
- April 17, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 18, 2024
- Facility type
- Ancillary test site
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 2
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D2302968
- Lab name
- Victory Bay Residential Services I, LLC
- Address
- 19667 Trull Brook Dr, Tarzana, CA 91356
- Phone
- (856) 425-3764
Annual test volume the lab reported
- Waived tests
- 4,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Tarzana, CA
- A&a Home CareCertificate of Waiver, Home health agency05D2193535
- Aa Home Health Care ServicesCertificate of Waiver, Home health agency05D2342819
- Advanced Institute for Obstetrics andCertificate for Provider-Performed Microscopy Procedures, Other practitioner05D1021332
- All State Patient CareCertificate of Waiver, Home health agency05D2308189
- Allergy Asthma Care Center, Inc.Certificate of Waiver, Physician office05D2127936
- American Urgent Care CenterCertificate of Waiver, Other05D2138090
- Attentive Home Health IncCertificate of Waiver, Home health agency05D2190142
- Autumn Hill Behavioral Heath II, LLCCertificate of Waiver, Ancillary test site05D2335226
- Autumn Hills Behavioral Health, LLCCertificate of Waiver, Ancillary test site05D2325127
- Avanguard Surgery CenterCertificate of Waiver, Ambulatory surgery center05D1059354
Related
Questions
What is the CLIA number for Victory Bay Residential Services I, LLC in Tarzana?
05D2302968, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Victory Bay Residential Services I, LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2302968 expire?
The CMS file lists April 17, 2028 as the certificate expiration date; the certificate took effect April 18, 2026.