Covenant Lab Services

Primary specialty

Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X

Legal business name

COVENANT LAB SERVICES

Practice address

110 Lithia Pinecrest Rd Ste H, Office D
Brandon, FL 33511-5300

Phone

(813) 851-3140

Fax

(813) 851-3141

NPI assigned

Feb 25, 2022

Last updated

Feb 25, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Alicia Tucker

Title

Owner

Phone

(813) 851-3140

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1053067215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E JACKSON ST STE 2340",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025226",
            "telephone_number": "813-851-3140",
            "fax_number": "813-851-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LITHIA PINECREST RD STE H, OFFICE D",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115300",
            "telephone_number": "813-851-3140",
            "fax_number": "813-851-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT LAB SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-25",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-851-3140",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "247ZC0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Laboratory Director (Non-physician) in Brandon, FL
• Providers in Brandon, FL by specialty
• Clinical Laboratory Director (Non-physician) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.