10D2306790 CLIA NUMBER - GRACE PEDIATRICS PL

Laboratory Demographics

  • CLIA Code: 10D2306790
  • Facility Name: GRACE PEDIATRICS PL
  • Facility Address: 238 SW CULLEN AVE
    FORT WHITE, FL
    ZIP 32038
  • Facility Phone: 386 243-8474
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: COLLEEN THOMPSON
  • NPI Number: 1326885294
  • Taxonomy: 261QR1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2306790
LAB Type Physician Office
Facility Name GRACE PEDIATRICS PL
Street 238 SW CULLEN AVE
City FORT WHITE
State FL
ZIP 32038
Phone 386 243-8474
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2024
Certificate Expiration Date 6/24/2026
Facility Type Physician Office
Lab Director COLLEEN THOMPSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025