05D2084948 CLIA NUMBER - HANNON CHIROPRACTIC

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Laboratory Demographics

CLIA Number: 05D2084948

Facility Name: HANNON CHIROPRACTIC

Facility Address:
16808 MAIN ST STE B ,
HESPERIA, CA
ZIP 92345
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Facility Phone Number: 760 949-0996

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1750612289

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	05D2084948
LAB Type	Practitioner Other
Facility Name	HANNON CHIROPRACTIC
Street	16808 MAIN ST STE B ,
City	HESPERIA
State	CA
ZIP	92345
Phone	760 949-0996
CertificateType	4
CertificateEffectiveDate	10/6/2022
CertificateExpirationDate	10/5/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024