49D2299623 CLIA NUMBER - GRACE HEALTH SERVICES LLC

Laboratory Demographics

  • CLIA Code: 49D2299623
  • Facility Name: GRACE HEALTH SERVICES LLC
  • Facility Address: 188 ONVILLE ROAD
    STAFFORD, VA
    ZIP 22556
  • Facility Phone: 888 887-6867
  • Facility Type: Other - MENTAL HEALTH PROVIDER
  • Facility Type: Waiver
  • Lab Director: COLLETTE F. NGANTE
  • NPI Number: 1528614674
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 49D2299623
LAB Type Other - MENTAL HEALTH PROVIDER
Facility Name GRACE HEALTH SERVICES LLC
Street 188 ONVILLE ROAD
City STAFFORD
State VA
ZIP 22556
Phone 888 887-6867
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2024
Certificate Expiration Date 2/22/2026
Facility Type Other - MENTAL HEALTH PROVIDER
Lab Director COLLETTE F. NGANTE

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