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General NPI Number Information
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NPI Number | 1194751081
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO MAGDALENA INC.
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 07/18/2016
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Provider Practice Location Address
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Address Line | 1452 ASHFORD AVE SUITE 309
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City | SAN JUAN
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State | PR
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Zip | 00907-1563
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Country | US
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Telephone | 787-725-5235
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Fax | 787-725-5229
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Provider Business Mailing Address
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Address Line | 1452 ASHFORD AVE SUITE 309
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City | SAN JUAN
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State | PR
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Zip | 00907-1563
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Country | US
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Telephone | 787-725-5235
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Fax | 787-725-5229
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Authorized Official
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Title or Position | OWNER/GENERAL SUPERVISOR
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Name | MRS. LIZETTE J. TORRES
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Credential | M.T.
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Telephone | 787-725-5235
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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 | 579
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License Number State | PR
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