44D2083451 CLIA NUMBER - GRACE PEDIATRICS, PLLC

Laboratory Demographics

  • CLIA Code: 44D2083451
  • Facility Name: GRACE PEDIATRICS, PLLC
  • Facility Address: 990 ELLISON WAY, SUITE 100
    THOMPSONS STATION, TN
    ZIP 37179
  • Facility Phone: 615 550-5221
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SAMORI CUMMINGS
  • NPI Number: 1710735220
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 44D2083451
LAB Type Physician Office
Facility Name GRACE PEDIATRICS, PLLC
Street 990 ELLISON WAY, SUITE 100
City THOMPSONS STATION
State TN
ZIP 37179
Phone 615 550-5221
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2025
Certificate Expiration Date 8/31/2027
Facility Type Physician Office
Lab Director DR. SAMORI CUMMINGS

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