26D0917793 CLIA NUMBER - SUMMIT VILLA LIFECARE

Laboratory Demographics

  • CLIA Code: 26D0917793
  • Facility Name: SUMMIT VILLA LIFECARE
  • Facility Address: 229 KAREN DRIVE
    HOLTS SUMMIT, MO
    ZIP 65043
  • Facility Phone: 573 896-8567
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MICHELE FEDORCHALK
  • NPI Number: 1265620199
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0917793
LAB Type Assisted Living Facility
Facility Name SUMMIT VILLA LIFECARE
Street 229 KAREN DRIVE
City HOLTS SUMMIT
State MO
ZIP 65043
Phone 573 896-8567
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/25/2024
Certificate Expiration Date 7/24/2026
Facility Type Assisted Living Facility
Lab Director MICHELE FEDORCHALK

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