Healthcare Provider Details

I. General information

NPI: 1891906913
Provider Name (Legal Business Name): USVI CLINICAL LABORATORIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 SUGAR STATE ROAD SUITE NUMBER 3
ST THOMAS VI
00802
US

IV. Provider business mailing address

1401 SUGAR STATE ROAD SUITE NUMBER 3
ST THOMAS VI
00802
US

V. Phone/Fax

Practice location:
  • Phone: 340-774-8847
  • Fax: 340-777-8805
Mailing address:
  • Phone: 340-774-8847
  • Fax: 340-777-8805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number1-2012052-2005
License Number StateVI

VIII. Authorized Official

Name: LUISA IDALIA BECERRA
Title or Position: PRESIDENT
Credential: BSMT, MHSA
Phone: 787-620-9095