26D2117374 CLIA NUMBER - BROOKSIDE MANOR RESIDENTIAL CARE LLC

Laboratory Demographics

  • CLIA Code: 26D2117374
  • Facility Name: BROOKSIDE MANOR RESIDENTIAL CARE LLC
  • Facility Address: 2434 HWY H
    FARMINGTON, MO
    ZIP 63640
  • Facility Phone: 573 756-6434
  • Facility Type: Other - RCF
  • Facility Type: Waiver
  • Lab Director: STARLA DULWORTH
  • NPI Number: 1902008766
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D2117374
LAB Type Other - RCF
Facility Name BROOKSIDE MANOR RESIDENTIAL CARE LLC
Street 2434 HWY H
City FARMINGTON
State MO
ZIP 63640
Phone 573 756-6434
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2024
Certificate Expiration Date 8/15/2026
Facility Type Other - RCF
Lab Director STARLA DULWORTH

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