SPIRIT LAKE CBOC (1052) INSTITUTION (4)

Name	Value
NAME	SPIRIT LAKE CBOC
STATE	IOWA
STREET ADDR. 1	1850 ROYAL AVENUE
CITY	SPIRIT LAKE
ZIP	51360-9998
OFFICIAL VA NAME	SPIRIT LAKE CBOC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 23 PARENT FACILITY PARENT OF ASSOCIATION: SIOUX FALLS VA HCS
BILLING FACILITY NAME	SPIRIT LAKE VA CLINIC
EFFECTIVE DATE/TIME	2007-11-13 00:00:00 STATUS: ACTIVE NPI: 1881874337
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	CENTRAL
COUNTRY	USA
AGENCY CODE	VA
POINTER TO AGENCY	VA
STATION NUMBER	438GA
IDENTIFIER	CODING SYSTEM: VASTANUM ID: 438GA CODING SYSTEM: CLIA ID: 16D1077890