26D1096721 CLIA NUMBER - CHESTNUT GLEN ASSISTED LIVING

Laboratory Demographics

CLIA Number: 26D1096721

Facility Name: CHESTNUT GLEN ASSISTED LIVING

Facility Address:
121 KLONDIKE CROSSING
SAINT PETERS, MO
ZIP 63376
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Facility Phone Number: 636 928-4200

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1851513204

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	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
CertificateType	4
CertificateEffectiveDate	3/11/2023
CertificateExpirationDate	3/10/2025
FacilityType	Waiver

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