26D1051389 CLIA NUMBER - BRISTOL MANOR OF MACON

Laboratory Demographics

CLIA Number: 26D1051389

Facility Name: BRISTOL MANOR OF MACON

Facility Address:
707 RANCHLAND DRIVE
MACON, MO
ZIP 63552
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Facility Phone Number: 660 385-3020

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1912113242

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	26D1051389
LAB Type	Assisted Living Facility
Facility Name	BRISTOL MANOR OF MACON
Street	707 RANCHLAND DRIVE
City	MACON
State	MO
ZIP	63552
Phone	660 385-3020
CertificateType	4
CertificateEffectiveDate	3/1/2024
CertificateExpirationDate	2/28/2026
FacilityType	Waiver

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