26D0652411 CLIA NUMBER - LICKING NO 1 DBA HICKORY MANOR

Laboratory Demographics

  • CLIA Code: 26D0652411
  • Facility Name: LICKING NO 1 DBA HICKORY MANOR
  • Facility Address: 209 HICKORY
    LICKING, MO
    ZIP 65542
  • Facility Phone: 573 674-2111
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: LINDI SCHMITT
  • NPI Number: 1912424607
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0652411
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LICKING NO 1 DBA HICKORY MANOR
Street 209 HICKORY
City LICKING
State MO
ZIP 65542
Phone 573 674-2111
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 LINDI SCHMITT

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