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General NPI Number Information
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NPI Number | 1134762867
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO YANLUIS
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Dates
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Enumeration Date | 10/25/2019
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Last Update Date | 10/25/2019
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Provider Practice Location Address
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Address Line | REPARTO EMANUELLI # 6 COAMO, PUERTO RICO 00769
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City | COAMO
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State | PR
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Zip | 00769
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Country | US
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Telephone | 787-204-1427
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Fax |
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Provider Business Mailing Address
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Address Line | URB. VALLE ARRIBA CALLE ACASIA 197 COAMO PUERTO RICO
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City | COAMO
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State | PR
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Zip | 00769
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Country | US
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Telephone | 787-204-1427
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Fax |
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Authorized Official
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Title or Position | TECNOLOGA MEDICA
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Name | MRS. YANITZA CRUZ RIVERA
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Credential | LICENCIADA
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Telephone | 787-204-1427
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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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