26D0930427 CLIA NUMBER - TUKHS CREEKWOOD FAMILY CARE

Laboratory Demographics

  • CLIA Code: 26D0930427
  • Facility Name: TUKHS CREEKWOOD FAMILY CARE
  • Facility Address: 6420 N PROSPECT AVENUE
    GLADSTONE, MO
    ZIP 64119
  • Facility Phone: 913 945-9705
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT E. DATTILIO
  • NPI Number: 1417919283
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 26D0930427
LAB Type Physician Office
Facility Name TUKHS CREEKWOOD FAMILY CARE
Street 6420 N PROSPECT AVENUE
City GLADSTONE
State MO
ZIP 64119
Phone 913 945-9705
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2025
Certificate Expiration Date 12/31/2026
Facility Type Physician Office
Lab Director ROBERT E. DATTILIO

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