Healthcare Provider Details

I. General information

NPI: 1861043960
Provider Name (Legal Business Name): RW LAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2019
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. PR 173, KM6, HM5, SECTOR SAN JOSE, BO. RABANAL
CIDRA PR
00739
US

IV. Provider business mailing address

P.O. BOX 459
CIDRA PR
00739
US

V. Phone/Fax

Practice location:
  • Phone: 787-520-7390
  • Fax: 787-520-7108
Mailing address:
  • Phone: 787-520-7390
  • Fax: 787-520-7108

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: DR. ROBERT RIVERA QUILES
Title or Position: ADMINISTRATOR, PRESIDENT
Credential: MD
Phone: 787-603-2378