26D0967589 CLIA NUMBER - BRISTOL MANOR OF REPUBLIC

Laboratory Demographics

  • CLIA Code: 26D0967589
  • Facility Name: BRISTOL MANOR OF REPUBLIC
  • Facility Address: 634 EAST HWY 174
    REPUBLIC, MO
    ZIP 65738
  • Facility Phone: 417 732-8998
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JESSICA WRIGHT
  • NPI Number: 1144436114
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0967589
LAB Type Assisted Living Facility
Facility Name BRISTOL MANOR OF REPUBLIC
Street 634 EAST HWY 174
City REPUBLIC
State MO
ZIP 65738
Phone 417 732-8998
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2023
Certificate Expiration Date 11/16/2025
Facility Type Assisted Living Facility
Lab Director JESSICA WRIGHT

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