Healthcare Provider Details
I. General information
NPI: 1477421949
Provider Name (Legal Business Name): LS TESTING LAB CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/27/2025
Last Update Date: 10/27/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
CARR 10 KM 59.3 BO HATO VIEJO
ARECIBO PR
00612-8282
US
IV. Provider business mailing address
PO BOX 2170
UTUADO PR
00641-2170
US
V. Phone/Fax
- Phone: 787-816-2600
- Fax:
- Phone: 787-816-2600
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LISANDRA
SUAREZ GONZALEZ
Title or Position: LAB OWNER
Credential: BSMT
Phone: 787-316-2879