04D1003471 CLIA NUMBER - ELITE HOME HEALTH LHCG XLII, LLC

Laboratory Demographics

  • CLIA Code: 04D1003471
  • Facility Name: ELITE HOME HEALTH LHCG XLII, LLC
  • Facility Address: 2904 JENNY LIND RD, SUITE 9A
    FORT SMITH, AR
    ZIP 72901
  • Facility Phone: 479 494-7273
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: TRESSA JOHNSON
  • NPI Number: 1154668895
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 04D1003471
LAB Type Home Health Agency
Facility Name ELITE HOME HEALTH LHCG XLII, LLC
Street 2904 JENNY LIND RD, SUITE 9A
City FORT SMITH
State AR
ZIP 72901
Phone 479 494-7273
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2024
Certificate Expiration Date 8/29/2026
Facility Type Home Health Agency
Lab Director TRESSA JOHNSON

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