26D0447622 CLIA NUMBER - MARANATHA VILLAGE, INC

Laboratory Demographics

  • CLIA Code: 26D0447622
  • Facility Name: MARANATHA VILLAGE, INC
  • Facility Address: 233 E NORTON ROAD
    SPRINGFIELD, MO
    ZIP 65803
  • Facility Phone: 417 833-0016
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ELIZABETH J. KAPUSTKA
  • NPI Number: 1699765644
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0447622
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MARANATHA VILLAGE, INC
Street 233 E NORTON ROAD
City SPRINGFIELD
State MO
ZIP 65803
Phone 417 833-0016
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 ELIZABETH J. KAPUSTKA

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