26D0921971 CLIA NUMBER - EVERTRUE BREEZE PARK

Laboratory Demographics

  • CLIA Code: 26D0921971
  • Facility Name: EVERTRUE BREEZE PARK
  • Facility Address: 600 BREEZE PARK DRIVE
    SAINT CHARLES, MO
    ZIP 63304
  • Facility Phone: 636 720-3080
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: KELISEN TAYOAN THORNHILL
  • NPI Number: 1720172869
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0921971
LAB Type Other
Facility Name EVERTRUE BREEZE PARK
Street 600 BREEZE PARK DRIVE
City SAINT CHARLES
State MO
ZIP 63304
Phone 636 720-3080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2024
Certificate Expiration Date 11/11/2026
Facility Type Other
Lab Director KELISEN TAYOAN THORNHILL

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