26D0897911 CLIA NUMBER - NIXA FAMILY MEDICAL WALK IN CLINIC

Laboratory Demographics

CLIA Number: 26D0897911

Facility Name: NIXA FAMILY MEDICAL WALK IN CLINIC

Facility Address:
103 OLD WILDERNESS ROAD
NIXA, MO
ZIP 65714
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Facility Phone Number: 417 724-0308

Facility Type: Rural Health Clinic

Certificate Type: Microscopy

NPI Number: 1790906709

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	26D0897911
LAB Type	Rural Health Clinic
Facility Name	NIXA FAMILY MEDICAL WALK IN CLINIC
Street	103 OLD WILDERNESS ROAD
City	NIXA
State	MO
ZIP	65714
Phone	417 724-0308
CertificateType	3
CertificateEffectiveDate	11/28/2022
CertificateExpirationDate	11/27/2024
FacilityType	PPMP

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