26D0652124 CLIA NUMBER - CLARK COUNTY NURSING HOME

Laboratory Demographics

  • CLIA Code: 26D0652124
  • Facility Name: CLARK COUNTY NURSING HOME
  • Facility Address: 1260 N JOHNSON ST
    KAHOKA, MO
    ZIP 63445
  • Facility Phone: 660 727-3303
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JEFFREY DAVIS
  • NPI Number: 1194718908
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0652124
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CLARK COUNTY NURSING HOME
Street 1260 N JOHNSON ST
City KAHOKA
State MO
ZIP 63445
Phone 660 727-3303
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 JEFFREY DAVIS

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