36D0968165 CLIA NUMBER - OTTAWA CHIROPRACTIC CENTER INC

Laboratory Demographics

  • CLIA Code: 36D0968165
  • Facility Name: OTTAWA CHIROPRACTIC CENTER INC
  • Facility Address: 139 SOUTH WALNUT STREET
    OTTAWA, OH
    ZIP 45875
  • Facility Phone: 419 523-5737
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RONALD R. BLACK DC
  • NPI Number: 1427265040
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 36D0968165
LAB Type Physician Office
Facility Name OTTAWA CHIROPRACTIC CENTER INC
Street 139 SOUTH WALNUT STREET
City OTTAWA
State OH
ZIP 45875
Phone 419 523-5737
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2023
Certificate Expiration Date 12/2/2025
Facility Type Physician Office
Lab Director RONALD R. BLACK DC

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This page was last updated on: 9/29/2025