04D2116865 CLIA NUMBER - CENTERWELL HOME HEALTH KAH DEVELOPMENT 4, LLC

Laboratory Demographics

  • CLIA Code: 04D2116865
  • Facility Name: CENTERWELL HOME HEALTH KAH DEVELOPMENT 4, LLC
  • Facility Address: 222 WEST WASHINGTON STREET
    CAMDEN, AR
    ZIP 71701
  • Facility Phone: 870 498-4357
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: ANDREA K. BETTIS
  • NPI Number: 1710337738
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 04D2116865
LAB Type Home Health Agency
Facility Name CENTERWELL HOME HEALTH KAH DEVELOPMENT 4, LLC
Street 222 WEST WASHINGTON STREET
City CAMDEN
State AR
ZIP 71701
Phone 870 498-4357
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 K. BETTIS

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