04D2048232 CLIA NUMBER - CENTERWELL HOME HEALTH KAH DEVELOPMENT 4, LLC

Laboratory Demographics

  • CLIA Code: 04D2048232
  • Facility Name: CENTERWELL HOME HEALTH KAH DEVELOPMENT 4, LLC
  • Facility Address: 26 ARNOLD SPRINGS ROAD
    MELBOURNE, AR
    ZIP 72556
  • Facility Phone: 870 368-3472
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: MS. LISA JOHNSON
  • NPI Number: 1609228717
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 04D2048232
LAB Type Home Health Agency
Facility Name CENTERWELL HOME HEALTH KAH DEVELOPMENT 4, LLC
Street 26 ARNOLD SPRINGS ROAD
City MELBOURNE
State AR
ZIP 72556
Phone 870 368-3472
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/11/2024
Certificate Expiration Date 10/10/2026
Facility Type Home Health Agency
Lab Director MS. LISA JOHNSON

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