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COVENANT WOODWARD AVENUE
NPI 1073834818
Clinic/Center - Federally Qualified Health Center (FQHC) in Royal Oak, MI

Active since June 16, 2010CLIA Certified · 2 labs
27776 WOODWARD AVE, ROYAL OAK, MI 48067(248) 556-4900(248) 556-4950 Get Directions Write a Review

NPPES record last updated: May 18, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 18, 2022, Jan 6, 2021 (2 updates tracked since 2021).

About Covenant Woodward Avenue NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COVENANT WOODWARD AVENUE (NPI 1073834818) is a healthcare organization registered as a federally qualified health center (fqhc) in Royal Oak, Michigan and active in the NPI registry since June 2010. The organization holds 2 active CLIA laboratory certificates and lists Joslyn Pettway, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1073834818
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameCOVENANT COMMUNITY CARE, INC.
Location Address27776 WOODWARD AVERoyal Oak, MI 48067-0930
Mailing Address559 W Grand BlvdDetroit, MI 48216-2200 · (313) 554-0485
Phone(248) 556-4900
Fax(248) 556-4950
Organization SubpartNo
Authorized OfficialJoslyn PettwayChief Executive Officer · (313) 554-0485
Enumeration DateJune 16, 2010
Last NPPES UpdateMay 18, 20222 updates tracked since enumeration
NPPES CertifiedMay 18, 2022
✔ NPI 1073834818 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
License✔ Licensed in MI · 4704195855
27776 WOODWARD AVE, Royal Oak, MI 48067
Open in Google Maps ↗

Other Names 1

Other NameCovenant Woodward Avenue

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D1071126

Covenant Community Care Inc · Detroit, MI
Active · expires Jul 18, 2027
CLIA Number23D1071126
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJuly 19, 2025
Certificate Expiration DateJuly 18, 2027
Laboratory DirectorScott Stryd
Laboratory Phone(313) 554-0485
Laboratory LocationCovenant Community Care Inc5716 Michigan Ave, Ste 1100, Detroit, MI 48210
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 23D2282075

Covenant Community Care - Moross · Detroit, MI
Active · expires May 15, 2027
CLIA Number23D2282075
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateMay 16, 2025
Certificate Expiration DateMay 15, 2027
Laboratory DirectorSajel Nuwamanya
Laboratory Phone(313) 554-0485
Laboratory LocationCovenant Community Care - Moross20901 Moross, Detroit, MI 48236
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BRYAN DANIEL SOFEN M.D.
Dermatology (MOHS-Micrographic Surgery)
27776 WOODWARD AVE
ROYAL OAK, MI 48067
Oakland County (248) 355-5047
DR. MARLA NICOLE JAHNKE MD
Dermatology (Pediatric Dermatology)
27776 WOODWARD AVE
ROYAL OAK, MI 48067
Oakland County (313) 451-0090
MARIA C MASSOS LLMSW
Social Worker (Clinical)
27776 WOODWARD AVE
ROYAL OAK, MI 48067
Oakland County (248) 556-4909
MICHELLE N MCCLORY LCSW
Social Worker (Clinical)
27776 WOODWARD AVE
ROYAL OAK, MI 48067
Oakland County (248) 556-4900
BASE DERMATOLOGY, PC
Dermatology (MOHS-Micrographic Surgery)
27776 WOODWARD AVE
ROYAL OAK, MI 48067
Oakland County (248) 355-5047

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Covenant Community Care, Inc.'s NPI number?

The NPI number for Covenant Community Care, Inc. is 1073834818. It was assigned to this organization in the NPPES registry on June 16, 2010. The provider is also known as Covenant Woodward Avenue.

Where is Covenant Community Care, Inc. located?

Covenant Community Care, Inc. is located at 27776 Woodward Ave, Royal Oak, MI 48067. The listed phone number is (248) 556-4900.

What is Covenant Community Care, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Covenant Community Care, Inc. hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Covenant Community Care, Inc. was last updated on May 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.