Healthcare Provider Details

I. General information

NPI: 1194448407
Provider Name (Legal Business Name): COVE DIAGNOSTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6817 SOUTHPOINT PKWY STE 1503
JACKSONVILLE FL
32216-6298
US

IV. Provider business mailing address

6817 SOUTHPOINT PKWY STE 1503
JACKSONVILLE FL
32216-6298
US

V. Phone/Fax

Practice location:
  • Phone: 386-222-4199
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: IMRAN RAZA
Title or Position: OWNER
Credential:
Phone: 386-222-4199