26D2193644 CLIA NUMBER - MADISON MEDICAL CENTER

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Laboratory Demographics

CLIA Number: 26D2193644

Facility Name: MADISON MEDICAL CENTER

Facility Address:
611 WEST MAIN STREET
FREDERICKTOWN, MO
ZIP 63645
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Facility Phone Number: 573 783-3341

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1649357229

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	26D2193644
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	MADISON MEDICAL CENTER
Street	611 WEST MAIN STREET
City	FREDERICKTOWN
State	MO
ZIP	63645
Phone	573 783-3341
CertificateType	4
CertificateEffectiveDate	9/23/2022
CertificateExpirationDate	9/22/2024
FacilityType	Waiver

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