14D2274370 CLIA NUMBER - LA'SO MEDICAL

Laboratory Demographics

  • CLIA Code: 14D2274370
  • Facility Name: LA'SO MEDICAL
  • Facility Address: 3909A N BELT W
    BELLEVILLE, IL
    ZIP 62226
  • Facility Phone: (618) 746-1142
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: SONDA JOHNSON
  • NPI Number: 1629702253
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 14D2274370
LAB Type Practitioner Other
Facility Name LA'SO MEDICAL
Street 3909A N BELT W
City BELLEVILLE
State IL
ZIP 62226
Phone 6187461142
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2025
Certificate Expiration Date 1/2/2027
Facility Type Practitioner Other
Lab Director SONDA JOHNSON

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This page was last updated on: 5/18/2026