14D2091056 CLIA NUMBER - HUMAN SUPPORT SERVICES

Laboratory Demographics

  • CLIA Code: 14D2091056
  • Facility Name: HUMAN SUPPORT SERVICES
  • Facility Address: 988 N IL ROUTE 3
    WATERLOO, IL
    ZIP 62298
  • Facility Phone: 618 939-4444
  • Facility Type: Other - DASA (DMH) LICENSED FCLTY
  • Facility Type: Waiver
  • Lab Director: ROBERT COLE
  • NPI Number: 1245795251
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 14D2091056
LAB Type Other - DASA (DMH) LICENSED FCLTY
Facility Name HUMAN SUPPORT SERVICES
Street 988 N IL ROUTE 3
City WATERLOO
State IL
ZIP 62298
Phone 618 939-4444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2025
Certificate Expiration Date 2/3/2027
Facility Type Other - DASA (DMH) LICENSED FCLTY
Lab Director ROBERT COLE

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This page was last updated on: 9/29/2025