49D2259105 CLIA NUMBER - ELGREAT HEALTHCARE SERVICES LLC

Laboratory Demographics

CLIA Number: 49D2259105

Facility Name: ELGREAT HEALTHCARE SERVICES LLC

Facility Address:
2301 HILLIARD ROAD SUITE 4
RICHMOND, VA
ZIP 23233
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Facility Phone Number: 804 528-9752

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1922753193

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	49D2259105
LAB Type	Practitioner Other
Facility Name	ELGREAT HEALTHCARE SERVICES LLC
Street	2301 HILLIARD ROAD SUITE 4
City	RICHMOND
State	VA
ZIP	23233
Phone	804 528-9752
CertificateType	4
CertificateEffectiveDate	5/2/2022
CertificateExpirationDate	5/1/2024
FacilityType	Waiver

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