CLIA lab
CLIA 26D0652411: Licking No 1 DBA Hickory Manor
Licking, MO. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 26D0652411 belongs to Licking No 1 DBA Hickory Manor in Licking, MO.
Certificate of Waiver, effective September 1, 2026, expires August 31, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- September 1, 2026
- Certificate expiration
- August 31, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- December 23, 1992
- Facility type
- Skilled nursing or nursing facility
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 26D0652411
- Lab name
- Licking No 1 DBA Hickory Manor
- Address
- 209 Hickory St, Licking, MO 65542
- Phone
- (573) 674-2111
- Fax
- (573) 674-3586
Annual test volume the lab reported
- Waived tests
- 50
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Care facility at this address
- Hickory ManorCMS Care Compare ratings for the facility at the same street address
Other labs in Licking, MO
Related
Questions
What is the CLIA number for Licking No 1 DBA Hickory Manor in Licking?
26D0652411, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Licking No 1 DBA Hickory Manor hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 26D0652411 expire?
The CMS file lists August 31, 2028 as the certificate expiration date; the certificate took effect September 1, 2026.