Healthcare Provider Details

I. General information

NPI: 1154498350
Provider Name (Legal Business Name): LABORATORIO CLINICO LOMAR INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 06/05/2020
Certification Date: 06/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE PEDRO ARROYO #4
OROCOVIS PR
00720
US

IV. Provider business mailing address

CALLE PEDRO ARROYO #4
OROCOVIS PR
00720
US

V. Phone/Fax

Practice location:
  • Phone: 787-867-2907
  • Fax: 787-867-2907
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number725
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier800184
Identifier TypeOTHER
Identifier State
Identifier IssuerMMM
# 2
Identifier30620
Identifier TypeOTHER
Identifier State
Identifier IssuerSSS
# 3
Identifier20225C
Identifier TypeOTHER
Identifier State
Identifier IssuerPREFERRED MEDICAL CHOICE

VIII. Authorized Official

Name: MRS. EVELYN LARACUENTE
Title or Position: DIRECTOR
Credential:
Phone: 787-867-2907