49D2109696 CLIA NUMBER - CENTRA PACE - GRETNA

Laboratory Demographics

CLIA Code: 49D2109696
Facility Name: CENTRA PACE - GRETNA
Facility Address: 1220 W GRETNA ROAD
GRETNA, VA
ZIP 24557
Facility Phone: 434 200-7000
Facility Type: Other - PACE PROGRAM
Facility Type: Waiver
Lab Director: LAURA HOWARD
NPI Number: 1972969871
Taxonomy: 251T00000X - Program of All-Inclusive Care for the Elderly (PACE) Provider Organization

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CLIA Record

Field Name	Field Value
CLIA Number	49D2109696
LAB Type	Other - PACE PROGRAM
Facility Name	CENTRA PACE - GRETNA
Street	1220 W GRETNA ROAD
City	GRETNA
State	VA
ZIP	24557
Phone	434 200-7000
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	3/1/2024
Certificate Expiration Date	2/28/2026
Facility Type	Other - PACE PROGRAM
Lab Director	LAURA HOWARD

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