19D2272959 CLIA NUMBER - GRACE MIDWIFERY COLLECTIVE

Laboratory Demographics

  • CLIA Code: 19D2272959
  • Facility Name: GRACE MIDWIFERY COLLECTIVE
  • Facility Address: 340 BRAKEFIELD ST
    SLIDELL, LA
    ZIP 70458
  • Facility Phone: 985 605-0027
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: GRACE L. JACKSON
  • NPI Number: 1578331971
  • Taxonomy: 261QB0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D2272959
LAB Type Independent
Facility Name GRACE MIDWIFERY COLLECTIVE
Street 340 BRAKEFIELD ST
City SLIDELL
State LA
ZIP 70458
Phone 985 605-0027
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2024
Certificate Expiration Date 12/1/2026
Facility Type Independent
Lab Director GRACE L. JACKSON

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