52D2188992 CLIA NUMBER - BAYCARE HEALTH SYSTEMS, LLC

Laboratory Demographics

CLIA Number: 52D2188992

Facility Name: BAYCARE HEALTH SYSTEMS, LLC

Facility Address:
1035 KEPLER DR
GREEN BAY, WI
ZIP 54311
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Facility Phone Number: 920 490-9046

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1780774760

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	52D2188992
LAB Type	Practitioner Other
Facility Name	BAYCARE HEALTH SYSTEMS, LLC
Street	1035 KEPLER DR
City	GREEN BAY
State	WI
ZIP	54311
Phone	920 490-9046
CertificateType	4
CertificateEffectiveDate	7/24/2022
CertificateExpirationDate	7/23/2024
FacilityType	Waiver

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