26D1080201 CLIA NUMBER - GIBSON CENTER FOR BEHAVIORAL CHANGE

Laboratory Demographics

  • CLIA Code: 26D1080201
  • Facility Name: GIBSON CENTER FOR BEHAVIORAL CHANGE
  • Facility Address: 1112 LINDEN STREET
    CAPE GIRARDEAU, MO
    ZIP 63703
  • Facility Phone: 573 332-0416
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: RYAN ESSEX
  • NPI Number: 1184774275
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 26D1080201
LAB Type Comp. Outpatient Rehab Facility
Facility Name GIBSON CENTER FOR BEHAVIORAL CHANGE
Street 1112 LINDEN STREET
City CAPE GIRARDEAU
State MO
ZIP 63703
Phone 573 332-0416
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/15/2024
Certificate Expiration Date 2/14/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director RYAN ESSEX

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