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General NPI Number Information
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NPI Number | 1073512315
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO SAGRADO CORAZON, INC
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 370 AVE SAN CLAUDIO URB. SAGRADO CORAZON
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City | SAN JUAN
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State | PR
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Zip | 00926-4107
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Country | US
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Telephone | 787-761-5193
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Fax | 787-755-4902
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Provider Business Mailing Address
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Address Line | 352 AVE SAN CLAUDIO STE 199 URB. SAGRADO CORAZON
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City | SAN JUAN
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State | PR
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Zip | 00926-4107
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Country | US
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Telephone | 787-761-5193
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Fax | 787-755-4902
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Authorized Official
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Title or Position | CLINICAL LABORATORY DIRECTOR
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Name | MARIA T LEBRON
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Credential | BSMT
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Telephone | 787-761-5193
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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 | 496
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License Number State | PR
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