DECORAH CBOC (3860) INSTITUTION (4)

Name	Value
NAME	DECORAH CBOC
STATE	IOWA
STREET ADDR. 1	915 SHORT STREET
CITY	DECORAH
ZIP	52101-2412
OFFICIAL VA NAME	DECORAH CBOC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 23 PARENT FACILITY PARENT OF ASSOCIATION: IOWA CITY HCS
BILLING FACILITY NAME	DECORAH VA CBOC
EFFECTIVE DATE/TIME	2012-01-23 00:00:00 STATUS: ACTIVE NPI: 1376817148
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	636GU
IDENTIFIER	CODING SYSTEM: CLIA ID: 16D2037941