15D1090214 CLIA NUMBER - VINCENNES CBOC

Laboratory Demographics

CLIA Number: 15D1090214

Facility Name: VINCENNES CBOC

Facility Address:
1813 WILLOW ST
VINCENNES, IN
ZIP 47591
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Facility Phone Number: 812 882-0894

Facility Type: Ambulatory Surgery Center

Certificate Type: Accreditation

NPI Number: 1376748996

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	15D1090214
LAB Type	Ambulatory Surgery Center
Facility Name	VINCENNES CBOC
Street	1813 WILLOW ST
City	VINCENNES
State	IN
ZIP	47591
Phone	812 882-0894
CertificateType	1
CertificateEffectiveDate	10/6/2008
CertificateExpirationDate	5/22/2026
FacilityType	Accreditation

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