26D0446125 CLIA NUMBER - JEFFERSON CITY MANOR

Laboratory Demographics

  • CLIA Code: 26D0446125
  • Facility Name: JEFFERSON CITY MANOR
  • Facility Address: 1720 VIETH DRIVE
    JEFFERSON CITY, MO
    ZIP 65109
  • Facility Phone: 573 635-6193
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: RACHEL L. PATTERSON
  • NPI Number: 1962507459
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 26D0446125
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name JEFFERSON CITY MANOR
Street 1720 VIETH DRIVE
City JEFFERSON CITY
State MO
ZIP 65109
Phone 573 635-6193
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2024
Certificate Expiration Date 10/25/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director RACHEL L. PATTERSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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