26D0719530 CLIA NUMBER - PARKDALE MANOR HEALTH AND REHABILITATION

Laboratory Demographics

  • CLIA Code: 26D0719530
  • Facility Name: PARKDALE MANOR HEALTH AND REHABILITATION
  • Facility Address: 814 W SOUTH AVE
    MARYVILLE, MO
    ZIP 64468
  • Facility Phone: 660 582-8161
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JENNIFER L. JEWETT
  • NPI Number: 1497850978
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0719530
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PARKDALE MANOR HEALTH AND REHABILITATION
Street 814 W SOUTH AVE
City MARYVILLE
State MO
ZIP 64468
Phone 660 582-8161
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 JENNIFER L. JEWETT

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