26D2121569 CLIA NUMBER - WAGNER RESIDENTIAL CARE INC

Laboratory Demographics

  • CLIA Code: 26D2121569
  • Facility Name: WAGNER RESIDENTIAL CARE INC
  • Facility Address: 320 N CHAMBER DR
    FREDERICKTOWN, MO
    ZIP 63645
  • Facility Phone: 573 783-4511
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TEENA D. WAGNER
  • NPI Number: 1154673887
  • Taxonomy: 310400000X - Assisted Living Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 26D2121569
LAB Type Assisted Living Facility
Facility Name WAGNER RESIDENTIAL CARE INC
Street 320 N CHAMBER DR
City FREDERICKTOWN
State MO
ZIP 63645
Phone 573 783-4511
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2024
Certificate Expiration Date 11/7/2026
Facility Type Assisted Living Facility
Lab Director TEENA D. WAGNER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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