45D2235041 CLIA NUMBER - ELITE HEALTHCARE SERVICES, LLC

Laboratory Demographics

CLIA Number: 45D2235041

Facility Name: ELITE HEALTHCARE SERVICES, LLC

Facility Address:
190 ABNER JACKSON PKWY SUITE 200
LAKE JACKSON, TX
ZIP 77566
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Facility Phone Number: 979 529-2520

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1194317156

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	45D2235041
LAB Type	Practitioner Other
Facility Name	ELITE HEALTHCARE SERVICES, LLC
Street	190 ABNER JACKSON PKWY SUITE 200
City	LAKE JACKSON
State	TX
ZIP	77566
Phone	979 529-2520
CertificateType	4
CertificateEffectiveDate	9/7/2023
CertificateExpirationDate	9/6/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024