26D0442080 CLIA NUMBER - JACKSON MANOR

Laboratory Demographics

  • CLIA Code: 26D0442080
  • Facility Name: JACKSON MANOR
  • Facility Address: 710 BROADRIDGE ST
    JACKSON, MO
    ZIP 63755
  • Facility Phone: 573 243-3101
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JOSEPH STARKE
  • NPI Number: 1457342289
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0442080
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name JACKSON MANOR
Street 710 BROADRIDGE ST
City JACKSON
State MO
ZIP 63755
Phone 573 243-3101
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 JOSEPH STARKE

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