26D0984641 CLIA NUMBER - BRISTOL MANOR OF CARTHAGE

Laboratory Demographics

CLIA Number: 26D0984641

Facility Name: BRISTOL MANOR OF CARTHAGE

Facility Address:
2131 S RIVER AVENUE
CARTHAGE, MO
ZIP 64836
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Facility Phone Number: 417 358-9788

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1417163056

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	26D0984641
LAB Type	Assisted Living Facility
Facility Name	BRISTOL MANOR OF CARTHAGE
Street	2131 S RIVER AVENUE
City	CARTHAGE
State	MO
ZIP	64836
Phone	417 358-9788
CertificateType	4
CertificateEffectiveDate	3/26/2023
CertificateExpirationDate	3/25/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024