26D0957280 CLIA NUMBER - ELLISVILLE OPCO LLC DBA ELLISVILLE REHABILITATION AND NURSING

Laboratory Demographics

  • CLIA Code: 26D0957280
  • Facility Name: ELLISVILLE OPCO LLC DBA ELLISVILLE REHABILITATION AND NURSING
  • Facility Address: 322 OLD STATE ROAD
    ELLISVILLE, MO
    ZIP 63021
  • Facility Phone: 636 227-3431
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CHERYL HANNERS
  • NPI Number: 1922074111
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D0957280
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ELLISVILLE OPCO LLC DBA ELLISVILLE REHABILITATION AND NURSING
Street 322 OLD STATE ROAD
City ELLISVILLE
State MO
ZIP 63021
Phone 636 227-3431
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2025
Certificate Expiration Date 2/16/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CHERYL HANNERS

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This page was last updated on: 3/20/2025