26D1059109 CLIA NUMBER - COUNTRYSIDE CARE CENTER, LLC

Laboratory Demographics

  • CLIA Code: 26D1059109
  • Facility Name: COUNTRYSIDE CARE CENTER, LLC
  • Facility Address: 385 S EISENHOWER ST
    MONETT, MO
    ZIP 65708
  • Facility Phone: 417 235-4040
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MARY K. HOWLETT
  • NPI Number: 1568818607
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D1059109
LAB Type Assisted Living Facility
Facility Name COUNTRYSIDE CARE CENTER, LLC
Street 385 S EISENHOWER ST
City MONETT
State MO
ZIP 65708
Phone 417 235-4040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2024
Certificate Expiration Date 9/21/2026
Facility Type Assisted Living Facility
Lab Director MARY K. HOWLETT

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