26D1025922 CLIA NUMBER - COUNTRY VALLEY HOME

Laboratory Demographics

  • CLIA Code: 26D1025922
  • Facility Name: COUNTRY VALLEY HOME
  • Facility Address: 15750 CR 2430
    SAINT JAMES, MO
    ZIP 65559
  • Facility Phone: 573 265-8250
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MARY V. HUTCHISON
  • NPI Number: 1952444580
  • Taxonomy: 3104A0625X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D1025922
LAB Type Assisted Living Facility
Facility Name COUNTRY VALLEY HOME
Street 15750 CR 2430
City SAINT JAMES
State MO
ZIP 65559
Phone 573 265-8250
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2024
Certificate Expiration Date 5/20/2026
Facility Type Assisted Living Facility
Lab Director MARY V. HUTCHISON

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