GRACELIGHT COMMUNITY HEALTH
NPI 1740835743
Clinic/Center - Federally Qualified Health Center (FQHC) in Los Angeles, CA

Active since August 06, 2019CLIA 05D2181711 · Waiver
303 LOMA DR STE 202, LOS ANGELES, CA 90017(323) 635-1140 Get Directions Write a Review

NPPES record last updated: June 27, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 27, 2024, Jan 26, 2021, Aug 6, 2019 (3 updates tracked since 2019).

About Gracelight Community Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRACELIGHT COMMUNITY HEALTH (NPI 1740835743), doing business as Queenscare Health Centers, is a healthcare organization registered as a federally qualified health center (fqhc) in Los Angeles, California and active in the NPI registry since August 2019. The organization holds a CLIA Waiver certificate valid through April 8, 2028 and lists Eloisa Perard, President & Ceo, as its authorized official.

NPPES Registry Identity

NPI1740835743
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameGRACELIGHT COMMUNITY HEALTH
Location Address303 LOMA DR STE 202Los Angeles, CA 90017-1103
Mailing Address4816 E 3rd StLos Angeles, CA 90022-1602 · (323) 780-4510 · Fax (323) 981-1662
Organization SubpartNo
Authorized OfficialEloisa PerardPresident & Ceo · (323) 669-4321
Enumeration DateAugust 6, 2019
Last NPPES UpdateJune 27, 20243 updates tracked since enumeration
NPPES CertifiedJune 27, 2024
NPI 1740835743 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
303 LOMA DR STE 202, Los Angeles, CA 90017

Other Names 1

Former Legal Business NameQueenscare Health Centers

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2181711

Gracelight Community Health · Los Angeles, CA
Active · expires Apr 8, 2028
CLIA Number05D2181711
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateApril 9, 2026
Certificate Expiration DateApril 8, 2028
Laboratory DirectorGiselle De Carvalho
Laboratory Phone(213) 858-5126
Laboratory LocationGracelight Community Health303 Loma Dr Ste 202, Los Angeles, CA 90017
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
303 LOMA DR STE 202
LOS ANGELES, CA 90017
Pediatrics
303 LOMA DR STE 202
LOS ANGELES, CA 90017

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gracelight Community Health's NPI number?

The NPI number for Gracelight Community Health is 1740835743. It was assigned to this organization in the NPPES registry on August 6, 2019. The provider was formerly known as Queenscare Health Centers.

Where is Gracelight Community Health located?

Gracelight Community Health is located at 303 Loma Dr Ste 202, Los Angeles, CA 90017. The listed phone number is (323) 635-1140.

What is Gracelight Community Health's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Gracelight Community Health hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2181711) is associated with this NPI, valid through April 8, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Gracelight Community Health was last updated on June 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.