11D2005204 CLIA NUMBER - OAKS AT TUCKER

Laboratory Demographics

  • CLIA Code: 11D2005204
  • Facility Name: OAKS AT TUCKER
  • Facility Address: 1300 MONTREAL ROAD
    TUCKER, GA
    ZIP 30084
  • Facility Phone: 770 934-0034
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TAWANA JACKSON
  • NPI Number: 1740229707
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 11D2005204
LAB Type Assisted Living Facility
Facility Name OAKS AT TUCKER
Street 1300 MONTREAL ROAD
City TUCKER
State GA
ZIP 30084
Phone 770 934-0034
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2024
Certificate Expiration Date 3/22/2026
Facility Type Assisted Living Facility
Lab Director TAWANA JACKSON

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