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General NPI Number Information
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NPI Number | 1265538938
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO SAN CRISTOBAL INC
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 07/11/2008
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Provider Practice Location Address
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Address Line | CARR 183 KM 186
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City | LAS PIEDRAS
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State | PR
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Zip | 00771
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Country | US
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Telephone | 787-733-7065
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Fax | 787-733-7065
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Provider Business Mailing Address
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Address Line | PO BOX 1600
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City | LAS PIEDRAS
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State | PR
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Zip | 00771-1600
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Country | US
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Telephone | 787-733-7065
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Fax | 787-733-7065
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JEANNETTE TORRES-RIVERA
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Credential | MT ASCP
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Telephone | 787-733-7065
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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 | 1098
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License Number State | PR
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