26D1096721 CLIA NUMBER - CHESTNUT GLEN ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 26D1096721
  • Facility Name: CHESTNUT GLEN ASSISTED LIVING
  • Facility Address: 121 KLONDIKE CROSSING
    SAINT PETERS, MO
    ZIP 63376
  • Facility Phone: 636 928-4200
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: COLLEEN M. HANNIBAL
  • NPI Number: 1851513204
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D1096721
LAB Type Assisted Living Facility
Facility Name CHESTNUT GLEN ASSISTED LIVING
Street 121 KLONDIKE CROSSING
City SAINT PETERS
State MO
ZIP 63376
Phone 636 928-4200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2025
Certificate Expiration Date 3/10/2027
Facility Type Assisted Living Facility
Lab Director COLLEEN M. HANNIBAL

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This page was last updated on: 6/4/2025