52D2264019 CLIA NUMBER - BLACK RIVER HEALTHCARE CLINIC - BLACK RIVER HEALTH, INC

Laboratory Demographics

  • CLIA Code: 52D2264019
  • Facility Name: BLACK RIVER HEALTHCARE CLINIC - BLACK RIVER HEALTH, INC
  • Facility Address: 711 W ADAMS ST
    BLACK RIVER FALLS, WI
    ZIP 54615
  • Facility Phone: 715 284-3223
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: ANGELA J. MARCIULIONIS
  • NPI Number: 1073514527
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 52D2264019
LAB Type Rural Health Clinic
Facility Name BLACK RIVER HEALTHCARE CLINIC - BLACK RIVER HEALTH, INC
Street 711 W ADAMS ST
City BLACK RIVER FALLS
State WI
ZIP 54615
Phone 715 284-3223
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/8/2024
Certificate Expiration Date 7/7/2026
Facility Type Rural Health Clinic
Lab Director ANGELA J. MARCIULIONIS

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