Organization
COVENANT HEALTHCARE LAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN J STEFANELLI (COO)
(386) 719-9915
Entity
Organization
Contact information
Practice address
305 CLYDE MORRIS BLVD, SUITE 290, ORMOND BEACH, FL 32174-8181
(386) 615-2100
(386) 236-0862
Mailing address
305 CLYDE MORRIS BLVD, SUITE 290, ORMOND BEACH, FL 32174-8181
(386) 615-2100
(386) 236-0862
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
10D1092594
FL
291U00000X
Clinical Medical Laboratory
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Other
Enumeration date
04/14/2011
Last updated
04/14/2011
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