48D1104068 CLIA NUMBER - GRAHAM UROLOGICAL CENTER LLC

Laboratory Demographics

  • CLIA Code: 48D1104068
  • Facility Name: GRAHAM UROLOGICAL CENTER LLC
  • Facility Address: 300 PETERS REST STE 1
    CHRISTIANSTED, VI
    ZIP 00820
  • Facility Phone: 340 719-8761
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EMMANUEL S. GRAHAM
  • NPI Number: 1205149879
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 48D1104068
LAB Type Physician Office
Facility Name GRAHAM UROLOGICAL CENTER LLC
Street 300 PETERS REST STE 1
City CHRISTIANSTED
State VI
ZIP 00820
Phone 340 719-8761
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2025
Certificate Expiration Date 8/24/2027
Facility Type Physician Office
Lab Director EMMANUEL S. GRAHAM

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