CLIA lab
CLIA 05D2339969: Walmart Pharmacy #10-1755
Rohnert Park, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2339969 belongs to Walmart Pharmacy #10-1755 in Rohnert Park, CA.
Certificate of Waiver, effective March 10, 2026, expires March 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
- March 10, 2026
- Certificate expiration
- March 9, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- March 10, 2026
- Facility type
- Pharmacy
- 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
- 05D2339969
- Lab name
- Walmart Pharmacy #10-1755
- Address
- 4625 Redwood Dr, Rohnert Park, CA 94928
- Phone
- (707) 586-3717
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.
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- Pain & Rehabilitative Consultants Medical GroupCertificate of Waiver, Physician office05D2033223
- Rohnert Park Health CenterCertificate for Provider-Performed Microscopy Procedures, Federally qualified health center05D2100777
- Rohnert Park Retirement CommunityCertificate of Waiver, Assisted living facility05D2217887
- ST. Joseph Mobile Health ClinicCertificate of Waiver, Mobile lab05D0944345
- Safeway Pharmacy # 0918Certificate of Waiver, Pharmacy05D2057765
- Satellite Healthcare Rohnert Park, LLCCertificate of Waiver, End stage renal disease dialysis facility05D2063744
- Sonoma State UniversityCertificate of Compliance, School or student health service05D0703841
- Sutter Pacific Medical FoundationCertificate for Provider-Performed Microscopy Procedures, Physician office05D0604492
- Tpmg Rohnert Park LaboratoryCertificate for Provider-Performed Microscopy Procedures, Ancillary test site05D1009732
Related
Questions
What is the CLIA number for Walmart Pharmacy #10-1755 in Rohnert Park?
05D2339969, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Walmart Pharmacy #10-1755 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2339969 expire?
The CMS file lists March 9, 2028 as the certificate expiration date; the certificate took effect March 10, 2026.