26D0962942 CLIA NUMBER - BRISTOL MANOR OF WILLARD

Laboratory Demographics

  • CLIA Code: 26D0962942
  • Facility Name: BRISTOL MANOR OF WILLARD
  • Facility Address: 511 WATSON
    WILLARD, MO
    ZIP 65781
  • Facility Phone: 417 742-0090
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TINA THOMAS
  • NPI Number: 1649486697
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0962942
LAB Type Assisted Living Facility
Facility Name BRISTOL MANOR OF WILLARD
Street 511 WATSON
City WILLARD
State MO
ZIP 65781
Phone 417 742-0090
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/16/2023
Certificate Expiration Date 7/15/2025
Facility Type Assisted Living Facility
Lab Director TINA THOMAS

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This page was last updated on: 3/20/2025