26D0441774 CLIA NUMBER - CAMELOT HEALTHCARE, LLC DBA CAMELOT NURSING AND REHABILITATION

Laboratory Demographics

  • CLIA Code: 26D0441774
  • Facility Name: CAMELOT HEALTHCARE, LLC DBA CAMELOT NURSING AND REHABILITATION
  • Facility Address: 705 GRAND CANYON DR
    FARMINGTON, MO
    ZIP 63640
  • Facility Phone: 573 756-8911
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: KRISTA CISSELL
  • NPI Number: 1760984587
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0441774
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CAMELOT HEALTHCARE, LLC DBA CAMELOT NURSING AND REHABILITATION
Street 705 GRAND CANYON DR
City FARMINGTON
State MO
ZIP 63640
Phone 573 756-8911
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director KRISTA CISSELL

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