25D2249942 CLIA NUMBER - GRACE MOBILE CARE LLC

Laboratory Demographics

  • CLIA Code: 25D2249942
  • Facility Name: GRACE MOBILE CARE LLC
  • Facility Address: 855 S PEAR ORCHARD RD STE 305
    RIDGELAND, MS
    ZIP 39157
  • Facility Phone: 769 300-0084
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: JENNIFER BOOSE
  • NPI Number: 1982356069
  • Taxonomy: 374U00000X - Home Health Aide

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CLIA Record

Field Name Field Value
CLIA Number 25D2249942
LAB Type Independent
Facility Name GRACE MOBILE CARE LLC
Street 855 S PEAR ORCHARD RD STE 305
City RIDGELAND
State MS
ZIP 39157
Phone 769 300-0084
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2024
Certificate Expiration Date 1/23/2026
Facility Type Independent
Lab Director JENNIFER BOOSE

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