24D2177677 CLIA NUMBER - ADVANCED CHIROPRACTIC OF MANKATO, PC

Laboratory Demographics

CLIA Number: 24D2177677

Facility Name: ADVANCED CHIROPRACTIC OF MANKATO, PC

Facility Address:
1712 JAMES DRIVE
MANKATO, MN
ZIP 56003
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Facility Phone Number: 507 385-2000

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1265508089

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	24D2177677
LAB Type	Physician Office
Facility Name	ADVANCED CHIROPRACTIC OF MANKATO, PC
Street	1712 JAMES DRIVE
City	MANKATO
State	MN
ZIP	56003
Phone	507 385-2000
CertificateType	4
CertificateEffectiveDate	1/16/2024
CertificateExpirationDate	1/15/2026
FacilityType	Waiver

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