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General NPI Number Information
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NPI Number | 1205889615
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO DCN CORP
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 01/28/2014
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Provider Practice Location Address
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Address Line | CANDOMINIO JESUS M SANROMA NUMBER 103 CALLE MUNOZ RIVERA
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City | CAROLINA
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State | PR
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Zip | 00985
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Country | US
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Telephone | 787-762-2280
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Fax | 787-782-9420
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Provider Business Mailing Address
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Address Line | 106 SUR MUNOZ RIVERA AVE.
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City | CAROLINA
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State | PR
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Zip | 00986
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Country | US
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Telephone | 787-762-2280
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Fax | 787-762-9420
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. VANESSA M HORTA GONZALEZ
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Credential |
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Telephone | 787-782-3627
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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 | 364
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License Number State | PR
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