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General NPI Number Information
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NPI Number | 1205817533
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Entity Type | Organization
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Legal Business Name | LABORATORIO NOCTURNO CAGUAS INC.
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Dates
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Enumeration Date | 11/14/2005
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Last Update Date | 10/02/2008
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Provider Practice Location Address
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Address Line | CALLE BORGONA 3B-5 VILLA DEL REY
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City | CAGUAS
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State | PR
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Zip | 00726
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Country | US
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Telephone | 787-744-2000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8307
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City | CAGUAS
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State | PR
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Zip | 00726-8307
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Country | US
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Telephone | 787-744-2000
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Fax | 787-743-4422
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Authorized Official
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Title or Position | MEDICAL TECHNOLOGY
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Name | MRS. LITZIA MARIE REYES
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Credential | MT ASCP
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Telephone | 787-744-2000
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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 | 471
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License Number State | PR
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