44D2161208 CLIA NUMBER - GRACE ADVANCED WELLNESS, LLC

Laboratory Demographics

  • CLIA Code: 44D2161208
  • Facility Name: GRACE ADVANCED WELLNESS, LLC
  • Facility Address: 543 E MAIN STREET
    HOHENWALD, TN
    ZIP 38462
  • Facility Phone: 931 295-3547
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: SUSAN A. HENSLEY
  • NPI Number: 1104536580
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 44D2161208
LAB Type Practitioner Other
Facility Name GRACE ADVANCED WELLNESS, LLC
Street 543 E MAIN STREET
City HOHENWALD
State TN
ZIP 38462
Phone 931 295-3547
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/29/2025
Certificate Expiration Date 1/28/2027
Facility Type Practitioner Other
Lab Director SUSAN A. HENSLEY

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