04D2157417 CLIA NUMBER - TUCKER CHIROPRACTIC CENTER, PLLC

Laboratory Demographics

  • CLIA Code: 04D2157417
  • Facility Name: TUCKER CHIROPRACTIC CENTER, PLLC
  • Facility Address: 1179 S GENTRY BLVD
    GENTRY, AR
    ZIP 72734
  • Facility Phone: 479 736-8900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEFFREY A. TUCKER
  • NPI Number: 1104848001
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 04D2157417
LAB Type Physician Office
Facility Name TUCKER CHIROPRACTIC CENTER, PLLC
Street 1179 S GENTRY BLVD
City GENTRY
State AR
ZIP 72734
Phone 479 736-8900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2024
Certificate Expiration Date 11/5/2026
Facility Type Physician Office
Lab Director JEFFREY A. TUCKER

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