52D2113358 CLIA NUMBER - BRE CHIROPRACTIC LLC

Laboratory Demographics

  • CLIA Code: 52D2113358
  • Facility Name: BRE CHIROPRACTIC LLC
  • Facility Address: 621 S GAMMON RD
    MADISON, WI
    ZIP 53719
  • Facility Phone: 608 630-9040
  • Facility Type: Other - CHIROPRACTIC CLINIC
  • Facility Type: Waiver
  • Lab Director: DR. BREANNA R. BALLWEG
  • NPI Number: 1942575287
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 52D2113358
LAB Type Other - CHIROPRACTIC CLINIC
Facility Name BRE CHIROPRACTIC LLC
Street 621 S GAMMON RD
City MADISON
State WI
ZIP 53719
Phone 608 630-9040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2024
Certificate Expiration Date 5/19/2026
Facility Type Other - CHIROPRACTIC CLINIC
Lab Director DR. BREANNA R. BALLWEG

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