CLIA lab
CLIA 05D2324028: The Optumserve - Amador Detert Park Labtestsite
Jackson, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2324028 belongs to The Optumserve - Amador Detert Park Labtestsite in Jackson, CA.
Certificate of Waiver, effective May 16, 2025, expires May 15, 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
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- May 16, 2025
- Certificate expiration
- May 15, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 16, 2025
- Facility type
- Independent
- 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
- 05D2324028
- Lab name
- The Optumserve - Amador Detert Park Labtestsite
- Address
- 899 N Main St, Detert Park, Jackson, CA 95642
- Phone
- (210) 287-9763
- Fax
- (608) 793-2900
Annual test volume the lab reported
- Waived tests
- 75,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Jackson, CA
- Amador Family Physicians Medical CorporationCertificate for Provider-Performed Microscopy Procedures, Physician office05D0984183
- Hospice of Amador & CalaverasCertificate of Waiver, Hospice05D0926617
- Irc-Sutter Health Jackson, LLCCertificate of Waiver, End stage renal disease dialysis facility05D2302474
- 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
Related
Questions
What is the CLIA number for The Optumserve - Amador Detert Park Labtestsite in Jackson?
05D2324028, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does The Optumserve - Amador Detert Park Labtestsite hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2324028 expire?
The CMS file lists May 15, 2027 as the certificate expiration date; the certificate took effect May 16, 2025.