26D2129297 CLIA NUMBER - THE VILLAS OF JACKSON

Laboratory Demographics

CLIA Number: 26D2129297

Facility Name: THE VILLAS OF JACKSON

Facility Address:
670 BROADRIDGE
JACKSON, MO
ZIP 63755
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Facility Phone Number: 573 986-8240

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1215438585

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	26D2129297
LAB Type	Assisted Living Facility
Facility Name	THE VILLAS OF JACKSON
Street	670 BROADRIDGE
City	JACKSON
State	MO
ZIP	63755
Phone	573 986-8240
CertificateType	4
CertificateEffectiveDate	4/18/2023
CertificateExpirationDate	4/17/2025
FacilityType	Waiver

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