Healthcare Provider Details

I. General information

NPI: 1427345768
Provider Name (Legal Business Name): HEALTH LABORATORIES SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2011
Last Update Date: 07/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENIDA FRAGOSO 3F S-6 VILLA FONTANA
CAROLINA PR
00983-0000
US

IV. Provider business mailing address

PO BOX 3310
CAROLINA PR
00984-3310
US

V. Phone/Fax

Practice location:
  • Phone: 787-750-7005
  • Fax: 787-750-7005
Mailing address:
  • Phone: 787-762-4786
  • Fax: 787-752-3360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number547
License Number StatePR

VIII. Authorized Official

Name: MR. JUAN CARLOS HERNANDEZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 787-762-4786