COVENANT LAB SERVICES
NPI 1053067215
Pathology - Clinical Laboratory Director, Non-physician in Brandon, FL

NPI Status: Active since February 25, 2022

Contact Information

110 LITHIA PINECREST RD STE H, OFFICE D
BRANDON, FL
ZIP 33511
Phone: (813) 851-3140
Fax: (813) 851-3141

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  • Organization
  • Pathology
  • Clinical Laboratory Director, Non-physic...
  • CLIA Number: 10D2253913
  • CLIA Cert. Type: Other - TEMPORARY TESTING SITE
  • CLIA Exp. Date: 02-24-2026

About COVENANT LAB SERVICES

This page provides the complete NPI Profile along with additional information for Covenant Lab Services, a provider established in Brandon, Florida operating as a Pathology, focusing in clinical laboratory director, non-physician . The healthcare provider is registered in the NPI registry with number 1053067215 assigned on February 2022. The practitioner's primary taxonomy code is 247ZC0005X. The provider is registered as an organization and their NPI record was last updated 4 years ago. Covenant Lab Services operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mrs. Alicia Tucker (Owner)

NPI
1053067215
Provider Name
COVENANT LAB SERVICES
Entity Type
Organization
Location Address
110 LITHIA PINECREST RD STE H, OFFICE D BRANDON, FL 33511
Location Phone
(813) 851-3140
Location Fax
(813) 851-3141
Mailing Address
401 E JACKSON ST STE 2340 TAMPA, FL 33602
Mailing Phone
(813) 851-3140
Mailing Fax
(813) 851-3141
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-25-2022
Last Update Date
02-25-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pathology Clinical Laboratory Director, Non-physician

Taxonomy Code
247ZC0005X
Type
Technologists, Technicians & Other Technical Service Providers
Taxonomy Description
An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. ALICIA TUCKER

Authorized Official Title
OWNER
Authorized Official Phone
(813) 851-3140

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
10D2253913
Facility Type
Other - TEMPORARY TESTING SITE
Certificate Effective Date
February 25, 2024
Certificate Expiration Date
February 24, 2026
Laboratory Director
ALICIA TUCKER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Covenant Lab Services to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1053067215, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 45. The final step is to find the difference between that total and the next multiple of ten (50 - 45 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
3
Unchanged
Pos 5
0
Doubled → 0
Pos 6
6
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
2
Unchanged
Pos 9
1
Doubled → 2
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 0 → 0 7 → 14 → 5 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 0 + 3 + 0 + 6 + 1 + 4 + 2 + 2 + 24 = 45

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 45 is 50. The difference is the calculated check digit.

50 - 45 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1053067215.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053067215, enumerated as an "organization" on February 25, 2022.

The provider is located at 110 LITHIA PINECREST RD STE H, OFFICE D BRANDON, FL 33511 and the phone number is (813) 851-3140.

Pathology with taxonomy code 247ZC0005X and a focus in Clinical Laboratory Director, Non-physician.