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General NPI Number Information
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NPI Number | 1104911981
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO SHAREM
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 08/14/2012
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Provider Practice Location Address
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Address Line | REG 295 DEL RIO SHOPPING VALLE TOLIMA
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City | CAGUAS
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State | PR
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Zip | 00727-2337
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Country | US
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Telephone | 787-703-1275
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Fax | 787-745-1370
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Provider Business Mailing Address
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Address Line | PO BOX 695
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City | CAGUAS
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State | PR
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Zip | 00726-0695
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Country | US
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Telephone | 787-703-1275
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Fax | 787-745-1370
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Authorized Official
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Title or Position | ADMINISTRACION
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Name | EMMA RODRIGUEZ
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Credential | M.T.
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Telephone | 787-312-7059
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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 | 997
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License Number State | PR
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