11D2302540 CLIA NUMBER - GREATER GRACE PRIVATE CARE LLC

Laboratory Demographics

  • CLIA Code: 11D2302540
  • Facility Name: GREATER GRACE PRIVATE CARE LLC
  • Facility Address: 5425 NEWTON ROAD, SUITE 4
    ALBANY, GA
    ZIP 31701
  • Facility Phone: 229 310-9479
  • Facility Type: Other - PRIVATE HOME CARE
  • Facility Type: Waiver
  • Lab Director: SHWANA JAY
  • NPI Number: 1952040487
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 11D2302540
LAB Type Other - PRIVATE HOME CARE
Facility Name GREATER GRACE PRIVATE CARE LLC
Street 5425 NEWTON ROAD, SUITE 4
City ALBANY
State GA
ZIP 31701
Phone 229 310-9479
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2024
Certificate Expiration Date 4/10/2026
Facility Type Other - PRIVATE HOME CARE
Lab Director SHWANA JAY

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