04D2116858 CLIA NUMBER - CENTERWELL HOME HEALTH KAH DEVELOPMENT 4, LLC

Laboratory Demographics

  • CLIA Code: 04D2116858
  • Facility Name: CENTERWELL HOME HEALTH KAH DEVELOPMENT 4, LLC
  • Facility Address: 925 NORTH WASHINGTON STREET
    FORREST CITY, AR
    ZIP 72335
  • Facility Phone: 870 270-5461
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: ANDREA COOPER
  • NPI Number: 1356793467
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 04D2116858
LAB Type Home Health Agency
Facility Name CENTERWELL HOME HEALTH KAH DEVELOPMENT 4, LLC
Street 925 NORTH WASHINGTON STREET
City FORREST CITY
State AR
ZIP 72335
Phone 870 270-5461
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/3/2024
Certificate Expiration Date 8/2/2026
Facility Type Home Health Agency
Lab Director ANDREA COOPER

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