10D2208579 CLIA NUMBER - COVENTRY ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 10D2208579
  • Facility Name: COVENTRY ASSISTED LIVING
  • Facility Address: 415 N WILDER RD
    PLANT CITY, FL
    ZIP 33566
  • Facility Phone: 813 704-6918
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: CHERRY HALLBACK
  • NPI Number: 1427393289
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2208579
LAB Type Assisted Living Facility
Facility Name COVENTRY ASSISTED LIVING
Street 415 N WILDER RD
City PLANT CITY
State FL
ZIP 33566
Phone 813 704-6918
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2025
Certificate Expiration Date 1/6/2027
Facility Type Assisted Living Facility
Lab Director CHERRY HALLBACK

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This page was last updated on: 9/29/2025