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General NPI Number Information
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NPI Number | 1043398241
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Entity Type | Organization
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Legal Business Name | CIDRA MEDICAL LABS INC
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 03/31/2014
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Provider Practice Location Address
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Address Line | 8 CALLE GAUTIER BENITEZ
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City | CIDRA
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State | PR
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Zip | 00739-3338
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Country | US
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Telephone | 787-739-4747
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Fax | 787-714-0522
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Provider Business Mailing Address
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Address Line | 8 CALLE GAUTIER BENITEZ
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City | CIDRA
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State | PR
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Zip | 00739-3338
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Country | US
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Telephone | 787-739-4747
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Fax | 787-714-0522
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Authorized Official
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Title or Position | LABORATORY DIRECTOR
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Name | MRS. MYRNA GARCIA
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Credential | BSMT ACSP
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Telephone | 787-747-7042
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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 |
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License Number State |
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