52D2303126 CLIA NUMBER - REILLY CHIROPRACTIC

Laboratory Demographics

  • CLIA Code: 52D2303126
  • Facility Name: REILLY CHIROPRACTIC
  • Facility Address: 4751 W PARK AVE
    LAKE HALLIE, WI
    ZIP 54729
  • Facility Phone: 715 723-2892
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. BROGHAN J. REILLY
  • NPI Number: 1518268655
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 52D2303126
LAB Type Practitioner Other
Facility Name REILLY CHIROPRACTIC
Street 4751 W PARK AVE
City LAKE HALLIE
State WI
ZIP 54729
Phone 715 723-2892
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Practitioner Other
Lab Director DR. BROGHAN J. REILLY

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