Provider Demographics
NPI:1285308015
Name:COVENANT LABORATORIES
Entity type:Organization
Organization Name:COVENANT LABORATORIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-953-9590
Mailing Address - Street 1:290 HANCOCK SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:BAY ST LOUIS
Mailing Address - State:MS
Mailing Address - Zip Code:39520-1634
Mailing Address - Country:US
Mailing Address - Phone:228-400-4790
Mailing Address - Fax:228-200-5683
Practice Address - Street 1:290 HANCOCK SQUARE DR
Practice Address - Street 2:
Practice Address - City:BAY ST LOUIS
Practice Address - State:MS
Practice Address - Zip Code:39520-1634
Practice Address - Country:US
Practice Address - Phone:228-400-4790
Practice Address - Fax:228-200-5683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-05
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory