Covenant Medical Diagnostics

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

031-039 Issued in GA

Legal business name

COVENANT MEDICAL DIAGNOSTICS

Practice address

2759 Mount Zion Pkwy
Suite a/B
Jonesboro, GA 30236-2568

Phone

(770) 471-8011

Fax

(678) 833-5506

NPI assigned

Jun 25, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael O Oyerinde, PH.D.NPI 1710129465

Title

Laboratory Director

Phone

(770) 471-8011

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael O Oyerinde, PH.D.

  • Clinical Medical Laboratory
  • Jonesboro, GA
  • NPI 1710129465
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245888000000",
    "number": "1043448392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2759 MOUNT ZION PKWY",
            "address_2": "SUITE A/B",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362568",
            "telephone_number": "770-471-8011",
            "fax_number": "678-833-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2759 MOUNT ZION PKWY",
            "address_2": "SUITE A/B",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362568",
            "telephone_number": "770-471-8011",
            "fax_number": "678-833-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT MEDICAL DIAGNOSTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-06-25",
        "status": "A",
        "authorized_official_last_name": "OYERINDE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "LABORATORY DIRECTOR",
        "authorized_official_telephone_number": "770-471-8011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "031-039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Clinical Medical Laboratory in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.