26D0856949 CLIA NUMBER - RIVERDELL CARE CENTER

Laboratory Demographics

  • CLIA Code: 26D0856949
  • Facility Name: RIVERDELL CARE CENTER
  • Facility Address: 1121 11TH STREET
    BOONVILLE, MO
    ZIP 65233
  • Facility Phone: 660 882-7600
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ROBERT H. KOCH
  • NPI Number: 1740212760
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0856949
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name RIVERDELL CARE CENTER
Street 1121 11TH STREET
City BOONVILLE
State MO
ZIP 65233
Phone 660 882-7600
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 ROBERT H. KOCH

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