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General NPI Number Information
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NPI Number | 1336108935
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Entity Type | Organization
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Legal Business Name | LAVORATORIO CLINICO SAN ANTONIO INC
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 08/07/2008
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Provider Practice Location Address
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Address Line | CARRETERA 402 KM 3.9 BARRIO CARACOL ANASCO
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City | ANASCO
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State | PR
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Zip | 00610
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Country | US
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Telephone | 787-826-7662
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Fax | 787-826-7662
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Provider Business Mailing Address
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Address Line | 35 VILLAS DE SOTOMAYOR
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City | AGUADO
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State | PR
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Zip | 00602
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Country | US
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Telephone | 787-252-8934
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Fax | 787-252-8934
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Authorized Official
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Title or Position | TECNOLOGO MEDICO
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Name | SHEILA BARRETO V
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Credential | BS MT
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Telephone | 787-826-7662
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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 |
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