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General NPI Number Information
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NPI Number | 1043329873
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO PUJOLS, INC.
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 10/17/2018
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Provider Practice Location Address
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Address Line | CARR. 111 KM. 17.0
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City | SAN SEBASTIAN
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State | PR
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Zip | 00685-7012
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Country | US
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Telephone | 787-896-7381
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Fax | 787-896-7381
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Provider Business Mailing Address
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Address Line | P.O. BOX 3692 HATO ARRIBA STATION
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City | SAN SEBASTIAN
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State | PR
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Zip | 00685-7012
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Country | US
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Telephone | 787-896-7381
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Fax | 787-896-7381
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Authorized Official
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Title or Position | ADMINISTRADORA
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Name | MRS. DAISY IVETTE SOTO
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Credential | BBA
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Telephone | 787-896-7381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 1022
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License Number State | PR
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