33D2055123 CLIA NUMBER - WILLIAM M TUCKER, MD, PLLC

Laboratory Demographics

  • CLIA Code: 33D2055123
  • Facility Name: WILLIAM M TUCKER, MD, PLLC
  • Facility Address: 4000 MEDICAL CENTER DRIVE, SUITE 207
    FAYETTEVILLE, NY
    ZIP 13066
  • Facility Phone: 315 637-1010
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. WILLIAM M. TUCKER
  • NPI Number: 1730273806
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 33D2055123
LAB Type Physician Office
Facility Name WILLIAM M TUCKER, MD, PLLC
Street 4000 MEDICAL CENTER DRIVE, SUITE 207
City FAYETTEVILLE
State NY
ZIP 13066
Phone 315 637-1010
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/6/2025
Certificate Expiration Date 3/5/2027
Facility Type Physician Office
Lab Director DR. WILLIAM M. TUCKER

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