26D0652113 CLIA NUMBER - SILEX RESIDENTIAL HOME, LLC

Laboratory Demographics

CLIA Number: 26D0652113

Facility Name: SILEX RESIDENTIAL HOME, LLC

Facility Address:
145 DUNCAN MANSION RD
SILEX, MO
ZIP 63377
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Facility Phone Number: 636 384-5213

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1821470436

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	26D0652113
LAB Type	Physician Office
Facility Name	SILEX RESIDENTIAL HOME, LLC
Street	145 DUNCAN MANSION RD
City	SILEX
State	MO
ZIP	63377
Phone	636 384-5213
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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