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General NPI Number Information
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NPI Number | 1255665261
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO SAN JUAN INC
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Dates
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Enumeration Date | 09/23/2009
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Last Update Date | 04/20/2018
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Provider Practice Location Address
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Address Line | PLAZA OLMEDO AVE LOMAS VERDES 1790
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-756-7128
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Fax | 787-765-1996
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Provider Business Mailing Address
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Address Line | 425 CARRETERA 693 PMB 132
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City | DORADO
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State | PR
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Zip | 00646-0000
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Country | US
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Telephone | 787-756-7128
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Fax | 787-765-1996
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARMEN L ARRIETA
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Credential |
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Telephone | 787-756-7128
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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 | PR
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