04D2050948 CLIA NUMBER - CENTERWELL HOME HEALTH KAH DEVELOPMENT 4, LLC

Laboratory Demographics

  • CLIA Code: 04D2050948
  • Facility Name: CENTERWELL HOME HEALTH KAH DEVELOPMENT 4, LLC
  • Facility Address: 1707 LINWOOD DRIVE, SUITE E
    PARAGOULD, AR
    ZIP 72450
  • Facility Phone: 870 586-5095
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: ERICA JOHNSON
  • NPI Number: 1932559952
  • Taxonomy: 251E00000X - Home Health

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 04D2050948
LAB Type Home Health Agency
Facility Name CENTERWELL HOME HEALTH KAH DEVELOPMENT 4, LLC
Street 1707 LINWOOD DRIVE, SUITE E
City PARAGOULD
State AR
ZIP 72450
Phone 870 586-5095
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2024
Certificate Expiration Date 12/9/2026
Facility Type Home Health Agency
Lab Director ERICA JOHNSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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