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Organization
COVENANT LAB SERVICES
Active
Organization
COVENANT LAB SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICIA TUCKER (OWNER)
(813) 851-3140
Entity
Organization
Contact information
Practice address
110 LITHIA PINECREST RD STE H, OFFICE D, BRANDON, FL 33511-5300
(813) 851-3140
(813) 851-3141
Mailing address
401 E JACKSON ST STE 2340, TAMPA, FL 33602-5226
(813) 851-3140
(813) 851-3141
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
—
NULL
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
—
—
Other
Enumeration date
02/25/2022
Last updated
02/25/2022
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