10D2198642 CLIA NUMBER - GRACE WELLNESS CENTER LLC

Laboratory Demographics

  • CLIA Code: 10D2198642
  • Facility Name: GRACE WELLNESS CENTER LLC
  • Facility Address: 2504 ACORN STREET, STE A
    FORT PIERCE, FL
    ZIP 34947
  • Facility Phone: (772) 837-7800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DIANA RAMIREZ
  • NPI Number: 1497371108
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2198642
LAB Type Physician Office
Facility Name GRACE WELLNESS CENTER LLC
Street 2504 ACORN STREET, STE A
City FORT PIERCE
State FL
ZIP 34947
Phone 7728377800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2026
Certificate Expiration Date 2/8/2028
Facility Type Physician Office
Lab Director DIANA RAMIREZ

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This page was last updated on: 5/18/2026