26D0442589 CLIA NUMBER - CARONDELET LTC FACILITIES, INC DBA ST MARY'S VILLAGE

Laboratory Demographics

  • CLIA Code: 26D0442589
  • Facility Name: CARONDELET LTC FACILITIES, INC DBA ST MARY'S VILLAGE
  • Facility Address: 111 NW MOCK AVE
    BLUE SPRINGS, MO
    ZIP 64014
  • Facility Phone: 816 228-5655
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JAMES PAULSGROVE
  • NPI Number: 1710979836
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0442589
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CARONDELET LTC FACILITIES, INC DBA ST MARY'S VILLAGE
Street 111 NW MOCK AVE
City BLUE SPRINGS
State MO
ZIP 64014
Phone 816 228-5655
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JAMES PAULSGROVE

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This page was last updated on: 6/4/2025