11D1046797 CLIA NUMBER - GRACE HOSPICE, LLC DBA HEART OF HOSPICE VALDOSTA

Laboratory Demographics

  • CLIA Code: 11D1046797
  • Facility Name: GRACE HOSPICE, LLC DBA HEART OF HOSPICE VALDOSTA
  • Facility Address: 515 NORTH SAINT AUGUSTINE ROAD, SUITE D
    VALDOSTA, GA
    ZIP 31601
  • Facility Phone: 229 333-5005
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: TRACIE KINNEBREW
  • NPI Number: 1598838468
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 11D1046797
LAB Type Hospice
Facility Name GRACE HOSPICE, LLC DBA HEART OF HOSPICE VALDOSTA
Street 515 NORTH SAINT AUGUSTINE ROAD, SUITE D
City VALDOSTA
State GA
ZIP 31601
Phone 229 333-5005
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2024
Certificate Expiration Date 7/12/2026
Facility Type Hospice
Lab Director TRACIE KINNEBREW

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