26D0952773 CLIA NUMBER - PLEASANT VALLEY MANOR

Laboratory Demographics

  • CLIA Code: 26D0952773
  • Facility Name: PLEASANT VALLEY MANOR
  • Facility Address: 213 DAVIS DRIVE
    WEST PLAINS, MO
    ZIP 65775
  • Facility Phone: 417 257-0179
  • Facility Type: Other - RESIDENTIAL CARE FACILITY
  • Facility Type: Waiver
  • Lab Director: JALYNN MOUSHON
  • NPI Number: 1942328117
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0952773
LAB Type Other - RESIDENTIAL CARE FACILITY
Facility Name PLEASANT VALLEY MANOR
Street 213 DAVIS DRIVE
City WEST PLAINS
State MO
ZIP 65775
Phone 417 257-0179
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2024
Certificate Expiration Date 10/19/2026
Facility Type Other - RESIDENTIAL CARE FACILITY
Lab Director JALYNN MOUSHON

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