26D0891146 CLIA NUMBER - SHELBINA VILLA LIFECARE

Laboratory Demographics

CLIA Number: 26D0891146

Facility Name: SHELBINA VILLA LIFECARE

Facility Address:
218 E SHELBINA AVE
SHELBINA, MO
ZIP 63468
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Facility Phone Number: 573 588-4115

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1972620987

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	26D0891146
LAB Type	Assisted Living Facility
Facility Name	SHELBINA VILLA LIFECARE
Street	218 E SHELBINA AVE
City	SHELBINA
State	MO
ZIP	63468
Phone	573 588-4115
CertificateType	4
CertificateEffectiveDate	8/31/2022
CertificateExpirationDate	8/30/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024