26D0968347 CLIA NUMBER - WALNUT STREET RESIDENTIAL CARE

Laboratory Demographics

  • CLIA Code: 26D0968347
  • Facility Name: WALNUT STREET RESIDENTIAL CARE
  • Facility Address: 404 WALNUT STREET
    DONIPHAN, MO
    ZIP 63935
  • Facility Phone: 573 996-4316
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ROBERT W. ADAMS
  • NPI Number: 1508987546
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0968347
LAB Type Assisted Living Facility
Facility Name WALNUT STREET RESIDENTIAL CARE
Street 404 WALNUT STREET
City DONIPHAN
State MO
ZIP 63935
Phone 573 996-4316
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2025
Certificate Expiration Date 5/29/2027
Facility Type Assisted Living Facility
Lab Director ROBERT W. ADAMS

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