26D0988737 CLIA NUMBER - BRISTOL MANOR OF CARROLLTON

Laboratory Demographics

CLIA Number: 26D0988737

Facility Name: BRISTOL MANOR OF CARROLLTON

Facility Address:
1016 E 10TH
CARROLLTON, MO
ZIP 64633
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Facility Phone Number: 660 542-2349

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1215143854

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	26D0988737
LAB Type	Assisted Living Facility
Facility Name	BRISTOL MANOR OF CARROLLTON
Street	1016 E 10TH
City	CARROLLTON
State	MO
ZIP	64633
Phone	660 542-2349
CertificateType	4
CertificateEffectiveDate	7/6/2023
CertificateExpirationDate	7/5/2025
FacilityType	Waiver

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