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General NPI Number Information
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NPI Number | 1104625045
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Entity Type | Organization
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Legal Business Name | LABORATORIO CIUDAD UNIVERSITARIA LLC
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | N16 CALLE AA
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976-3130
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Country | US
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Telephone | 787-755-2697
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 522
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City | CAGUAS
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State | PR
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Zip | 00726-0522
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ELVIN VAZQUEZ
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Credential |
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Telephone | 787-755-2697
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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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