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General NPI Number Information
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NPI Number | 1467441782
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO ANALITICO INC
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1326 CALLE SALUD STE 309
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City | PONCE
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State | PR
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Zip | 00717-1686
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Country | US
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Telephone | 787-290-4024
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Fax | 787-842-5327
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Provider Business Mailing Address
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Address Line | 1326 CALLE SALUD STE 309
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City | PONCE
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State | PR
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Zip | 00717-1686
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Country | US
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Telephone | 787-290-4024
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Fax | 787-842-5327
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Authorized Official
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Title or Position | PRESIDENT AND LABORATORY DIRECTOR
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Name | ALMA CARRASQUILLO
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Credential | ASCP
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Telephone | 787-290-4024
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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 | 437
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License Number State | PR
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