19D2244424 CLIA NUMBER - GRACE HEALTHCARE AND MEDICAL SOLUTION CENTER

Laboratory Demographics

  • CLIA Code: 19D2244424
  • Facility Name: GRACE HEALTHCARE AND MEDICAL SOLUTION CENTER
  • Facility Address: 9800 AIRLINE HWY, SUITE 105
    BATON ROUGE, LA
    ZIP 70816
  • Facility Phone: 225 262-1101
  • Facility Type: Other - STI/HIV CLINIC
  • Facility Type: Waiver
  • Lab Director: JUSTIN DYER
  • NPI Number: 1669074159
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 19D2244424
LAB Type Other - STI/HIV CLINIC
Facility Name GRACE HEALTHCARE AND MEDICAL SOLUTION CENTER
Street 9800 AIRLINE HWY, SUITE 105
City BATON ROUGE
State LA
ZIP 70816
Phone 225 262-1101
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2024
Certificate Expiration Date 10/13/2026
Facility Type Other - STI/HIV CLINIC
Lab Director JUSTIN DYER

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