14D2237127 CLIA NUMBER - BELLEVILLE AREA SPECIAL SERVICES COOP (BASSC)

Laboratory Demographics

  • CLIA Code: 14D2237127
  • Facility Name: BELLEVILLE AREA SPECIAL SERVICES COOP (BASSC)
  • Facility Address: 2411 PATHWAYS CROSSING
    BELLEVILLE, IL
    ZIP 62221
  • Facility Phone: 618 355-4422
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: JEFFREY R. DAUGHERTY
  • NPI Number: 1679090997
  • Taxonomy: 103TS0200X - Psychologist

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CLIA Record

Field Name Field Value
CLIA Number 14D2237127
LAB Type School/Student Health Service
Facility Name BELLEVILLE AREA SPECIAL SERVICES COOP (BASSC)
Street 2411 PATHWAYS CROSSING
City BELLEVILLE
State IL
ZIP 62221
Phone 618 355-4422
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2025
Certificate Expiration Date 9/21/2027
Facility Type School/Student Health Service
Lab Director JEFFREY R. DAUGHERTY

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