44D2229450 CLIA NUMBER - GRACE LAND RECOVERY LLC

Laboratory Demographics

CLIA Number: 44D2229450

Facility Name: GRACE LAND RECOVERY LLC

Facility Address:
134 TIMBER CREEK DRIVE
CORDOVA, TN
ZIP 38018
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Facility Phone Number: 404 444-6228

Facility Type: Independent

Certificate Type: Waiver

NPI Number: 1245821966

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D2229450
LAB Type	Independent
Facility Name	GRACE LAND RECOVERY LLC
Street	134 TIMBER CREEK DRIVE
City	CORDOVA
State	TN
ZIP	38018
Phone	404 444-6228
CertificateType	4
CertificateEffectiveDate	7/13/2023
CertificateExpirationDate	7/12/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024