04D1068194 CLIA NUMBER - ELITE HOSPICE PATIENT'S CHOICE HOSPICE, LLC

Laboratory Demographics

  • CLIA Code: 04D1068194
  • Facility Name: ELITE HOSPICE PATIENT'S CHOICE HOSPICE, LLC
  • Facility Address: 4200 N WASHINGTON STREET, SUITE 2
    FORREST CITY, AR
    ZIP 72335
  • Facility Phone: 870 633-4613
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: PAMELA JOHNSTON
  • NPI Number: 1134174139
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 04D1068194
LAB Type Hospice
Facility Name ELITE HOSPICE PATIENT'S CHOICE HOSPICE, LLC
Street 4200 N WASHINGTON STREET, SUITE 2
City FORREST CITY
State AR
ZIP 72335
Phone 870 633-4613
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Hospice
Lab Director PAMELA JOHNSTON

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