45D2311164 CLIA NUMBER - ELEVATED HOME CARE AGENCY LLC

Laboratory Demographics

  • CLIA Code: 45D2311164
  • Facility Name: ELEVATED HOME CARE AGENCY LLC
  • Facility Address: 5743 LASALLE WAY
    SAN ANTONIO, TX
    ZIP 78253
  • Facility Phone: 210 300-7713
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: JOHN-PAUL WIRBA
  • NPI Number: 1184315145
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 45D2311164
LAB Type Home Health Agency
Facility Name ELEVATED HOME CARE AGENCY LLC
Street 5743 LASALLE WAY
City SAN ANTONIO
State TX
ZIP 78253
Phone 210 300-7713
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2024
Certificate Expiration Date 9/16/2026
Facility Type Home Health Agency
Lab Director JOHN-PAUL WIRBA

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