24D2284996 CLIA NUMBER - WOODLANDS CHIROPRACTIC, PA

Laboratory Demographics

CLIA Number: 24D2284996

Facility Name: WOODLANDS CHIROPRACTIC, PA

Facility Address:
48 29TH AVE N
SAINT CLOUD, MN
ZIP 56303
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Facility Phone Number: 320 240-0300

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1710078407

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	24D2284996
LAB Type	Practitioner Other
Facility Name	WOODLANDS CHIROPRACTIC, PA
Street	48 29TH AVE N
City	SAINT CLOUD
State	MN
ZIP	56303
Phone	320 240-0300
CertificateType	4
CertificateEffectiveDate	7/3/2023
CertificateExpirationDate	7/2/2025
FacilityType	Waiver

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