26D0668342 CLIA NUMBER - ROLLA PRESBYTERIAN MANOR

Laboratory Demographics

  • CLIA Code: 26D0668342
  • Facility Name: ROLLA PRESBYTERIAN MANOR
  • Facility Address: 1200 HOMELIFE PLAZA
    ROLLA, MO
    ZIP 65401
  • Facility Phone: 573 364-7336
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: KRYSTAL GRISHAM
  • NPI Number: 1861503302
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0668342
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ROLLA PRESBYTERIAN MANOR
Street 1200 HOMELIFE PLAZA
City ROLLA
State MO
ZIP 65401
Phone 573 364-7336
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 KRYSTAL GRISHAM

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