26D0698084 CLIA NUMBER - BRENT B TINNIN MANOR

Laboratory Demographics

  • CLIA Code: 26D0698084
  • Facility Name: BRENT B TINNIN MANOR
  • Facility Address: RR 4 BOX 4253
    ELLINGTON, MO
    ZIP 63638
  • Facility Phone: 573 663-2545
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: RODNEY RUBI
  • NPI Number: 1629000690
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0698084
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BRENT B TINNIN MANOR
Street RR 4 BOX 4253
City ELLINGTON
State MO
ZIP 63638
Phone 573 663-2545
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 RODNEY RUBI

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