26D0969650 CLIA NUMBER - FREDERICK STREET MANOR

Laboratory Demographics

  • CLIA Code: 26D0969650
  • Facility Name: FREDERICK STREET MANOR
  • Facility Address: 429 N FREDERICK STREET
    CAPE GIRARDEAU, MO
    ZIP 63701
  • Facility Phone: 573 334-2662
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ANNAH J. VOSHAGE
  • NPI Number: 1194864447
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0969650
LAB Type Assisted Living Facility
Facility Name FREDERICK STREET MANOR
Street 429 N FREDERICK STREET
City CAPE GIRARDEAU
State MO
ZIP 63701
Phone 573 334-2662
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/21/2024
Certificate Expiration Date 1/20/2026
Facility Type Assisted Living Facility
Lab Director ANNAH J. VOSHAGE

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