26D0967057 CLIA NUMBER - MEADOWBROOK RESIDENTIAL CARE, INC

Laboratory Demographics

  • CLIA Code: 26D0967057
  • Facility Name: MEADOWBROOK RESIDENTIAL CARE, INC
  • Facility Address: 806 W MULBERRY
    PILOT KNOB, MO
    ZIP 63663
  • Facility Phone: 573 546-7065
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TONNIE D. JACKSON
  • NPI Number: 1619163235
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0967057
LAB Type Assisted Living Facility
Facility Name MEADOWBROOK RESIDENTIAL CARE, INC
Street 806 W MULBERRY
City PILOT KNOB
State MO
ZIP 63663
Phone 573 546-7065
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2023
Certificate Expiration Date 11/1/2025
Facility Type Assisted Living Facility
Lab Director TONNIE D. JACKSON

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