45D2322147 CLIA NUMBER - MEDI-ELITE HEALTH AND WELLNESS

Laboratory Demographics

  • CLIA Code: 45D2322147
  • Facility Name: MEDI-ELITE HEALTH AND WELLNESS
  • Facility Address: 2721 CENTRAL DRIVE
    BEDFORD, TX
    ZIP 76021
  • Facility Phone: 682 703-8881
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MAHALIA L. JACKSON-BUTLER
  • NPI Number: 1528330792
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2322147
LAB Type Practitioner Other
Facility Name MEDI-ELITE HEALTH AND WELLNESS
Street 2721 CENTRAL DRIVE
City BEDFORD
State TX
ZIP 76021
Phone 682 703-8881
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Practitioner Other
Lab Director MAHALIA L. JACKSON-BUTLER

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