19D2103936 CLIA NUMBER - GRACE OUTREACH CENTER

Laboratory Demographics

  • CLIA Code: 19D2103936
  • Facility Name: GRACE OUTREACH CENTER
  • Facility Address: 2237 POYDRAS STREET
    NEW ORLEANS, LA
    ZIP 70119
  • Facility Phone: 504 304-9980
  • Facility Type: Other - FSTRA
  • Facility Type: Waiver
  • Lab Director: PYTHIAN NOAH
  • NPI Number: 1578791836
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D2103936
LAB Type Other - FSTRA
Facility Name GRACE OUTREACH CENTER
Street 2237 POYDRAS STREET
City NEW ORLEANS
State LA
ZIP 70119
Phone 504 304-9980
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2023
Certificate Expiration Date 10/22/2025
Facility Type Other - FSTRA
Lab Director PYTHIAN NOAH

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