45D2028751 CLIA NUMBER - ELYSIAN HOSPICE HOUSTON LLC DBA ELYSIAN HOSPICE

Laboratory Demographics

  • CLIA Code: 45D2028751
  • Facility Name: ELYSIAN HOSPICE HOUSTON LLC DBA ELYSIAN HOSPICE
  • Facility Address: 11104 WEST AIRPORT BOULEVARD, SUITE 212B
    STAFFORD, TX
    ZIP 77477
  • Facility Phone: 281 333-2458
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: TINA FORTNER
  • NPI Number: 1881053643
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 45D2028751
LAB Type Hospice
Facility Name ELYSIAN HOSPICE HOUSTON LLC DBA ELYSIAN HOSPICE
Street 11104 WEST AIRPORT BOULEVARD, SUITE 212B
City STAFFORD
State TX
ZIP 77477
Phone 281 333-2458
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2025
Certificate Expiration Date 8/22/2027
Facility Type Hospice
Lab Director TINA FORTNER

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