24D2046110 CLIA NUMBER - WINNEBAGO CHIROPRACTIC LLC

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Laboratory Demographics

CLIA Number: 24D2046110

Facility Name: WINNEBAGO CHIROPRACTIC LLC

Facility Address:
115 1ST AVENUE NW
WINNEBAGO, MN
ZIP 56098
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Facility Phone Number: 507 893-4412

Facility Type: Other - CHIROPRACTIC OFFICE

Certificate Type: Waiver

NPI Number: 1942563978

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	24D2046110
LAB Type	Other - CHIROPRACTIC OFFICE
Facility Name	WINNEBAGO CHIROPRACTIC LLC
Street	115 1ST AVENUE NW
City	WINNEBAGO
State	MN
ZIP	56098
Phone	507 893-4412
CertificateType	4
CertificateEffectiveDate	8/27/2022
CertificateExpirationDate	8/26/2024
FacilityType	Waiver

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