Healthcare Provider Details

I. General information

NPI: 1992796999
Provider Name (Legal Business Name): LABORATORIO CLINICO SANTA ISABEL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 02/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 CALLE MUNOZ RIVERA
SANTA ISABEL PR
00757-2600
US

IV. Provider business mailing address

PO BOX 179
SANTA ISABEL PR
00757-0179
US

V. Phone/Fax

Practice location:
  • Phone: 787-845-6315
  • Fax: 787-845-6315
Mailing address:
  • Phone: 787-845-6315
  • Fax: 787-845-6315

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: MRS. SARAH FERNANDEZ
Title or Position: OWNER DIRECTOR
Credential:
Phone: 787-845-6315