04D0981316 CLIA NUMBER - ELITE HOME HEALTH LHCG XLII, LLC

Laboratory Demographics

  • CLIA Code: 04D0981316
  • Facility Name: ELITE HOME HEALTH LHCG XLII, LLC
  • Facility Address: 650 S SHACKELFORD ROAD, SUITE 303
    LITTLE ROCK, AR
    ZIP 72211
  • Facility Phone: 501 223-3333
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: BRITNEY ICENHOWER
  • NPI Number: 1447597182
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 04D0981316
LAB Type Home Health Agency
Facility Name ELITE HOME HEALTH LHCG XLII, LLC
Street 650 S SHACKELFORD ROAD, SUITE 303
City LITTLE ROCK
State AR
ZIP 72211
Phone 501 223-3333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2024
Certificate Expiration Date 12/21/2026
Facility Type Home Health Agency
Lab Director BRITNEY ICENHOWER

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