24D2075003 CLIA NUMBER - HANSON CHIROPRACTIC CLINIC, PA

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Laboratory Demographics

CLIA Number: 24D2075003

Facility Name: HANSON CHIROPRACTIC CLINIC, PA

Facility Address:
306 NORTH MILL STREET
FERTILE, MN
ZIP 56540
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Facility Phone Number: 218 945-3220

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1477589141

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	24D2075003
LAB Type	Physician Office
Facility Name	HANSON CHIROPRACTIC CLINIC, PA
Street	306 NORTH MILL STREET
City	FERTILE
State	MN
ZIP	56540
Phone	218 945-3220
CertificateType	4
CertificateEffectiveDate	3/20/2024
CertificateExpirationDate	3/19/2026
FacilityType	Waiver

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