45D2235041 CLIA NUMBER - ELITE HEALTHCARE SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 45D2235041
  • Facility Name: ELITE HEALTHCARE SERVICES, LLC
  • Facility Address: 190 ABNER JACKSON PKWY SUITE 200
    LAKE JACKSON, TX
    ZIP 77566
  • Facility Phone: 979 529-2520
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: NATALIE N. ROMAN
  • NPI Number: 1194317156
  • Taxonomy: 207Q00000X - Family Medicine

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/7/2023
Certificate Expiration Date 9/6/2025
Facility Type Practitioner Other
Lab Director NATALIE N. ROMAN

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This page was last updated on: 6/4/2025