26D0982150 CLIA NUMBER - BRISTOL MANOR OF MONTGOMERY CITY

Laboratory Demographics

  • CLIA Code: 26D0982150
  • Facility Name: BRISTOL MANOR OF MONTGOMERY CITY
  • Facility Address: 625 W 2ND STREET
    MONTGOMERY CITY, MO
    ZIP 63361
  • Facility Phone: 573 564-3386
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MIKE NELSON
  • NPI Number: 1174739031
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0982150
LAB Type Assisted Living Facility
Facility Name BRISTOL MANOR OF MONTGOMERY CITY
Street 625 W 2ND STREET
City MONTGOMERY CITY
State MO
ZIP 63361
Phone 573 564-3386
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2025
Certificate Expiration Date 1/16/2027
Facility Type Assisted Living Facility
Lab Director MIKE NELSON

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