24D2085042 CLIA NUMBER - NORTHGATE CHIROPRACTIC CLINIC, PA

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Laboratory Demographics

CLIA Number: 24D2085042

Facility Name: NORTHGATE CHIROPRACTIC CLINIC, PA

Facility Address:
600 11TH AVE NORTHWEST
ROCHESTER, MN
ZIP 55901
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Facility Phone Number: 507 285-1677

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1720153745

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	24D2085042
LAB Type	Practitioner Other
Facility Name	NORTHGATE CHIROPRACTIC CLINIC, PA
Street	600 11TH AVE NORTHWEST
City	ROCHESTER
State	MN
ZIP	55901
Phone	507 285-1677
CertificateType	4
CertificateEffectiveDate	10/7/2022
CertificateExpirationDate	10/6/2024
FacilityType	Waiver

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