Healthcare Provider Details

I. General information

NPI: 1659209724
Provider Name (Legal Business Name): LAB LORIMAR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 CALLE PEDRO SANTOS
MOCA PR
00676-4015
US

IV. Provider business mailing address

PO BOX 388
MOCA PR
00676-0388
US

V. Phone/Fax

Practice location:
  • Phone: 787-877-1236
  • 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: JORGE L MENDEZ COLON
Title or Position: PRESIDENT
Credential:
Phone: 787-877-7700