36D2283063 CLIA NUMBER - GOODWIN CHIROPRACTIC, LLC

Laboratory Demographics

CLIA Number: 36D2283063

Facility Name: GOODWIN CHIROPRACTIC, LLC

Facility Address:
4130 LINDEN AVE SUITE 125
DAYTON, OH
ZIP 45432
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Facility Phone Number: 937 952-6567

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1467984740

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	36D2283063
LAB Type	Physician Office
Facility Name	GOODWIN CHIROPRACTIC, LLC
Street	4130 LINDEN AVE SUITE 125
City	DAYTON
State	OH
ZIP	45432
Phone	937 952-6567
CertificateType	4
CertificateEffectiveDate	5/31/2023
CertificateExpirationDate	5/30/2025
FacilityType	Waiver

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