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General NPI Number Information
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NPI Number | 1467963900
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Entity Type | Organization
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Legal Business Name | LCSA LLC
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Dates
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Enumeration Date | 10/23/2017
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Last Update Date | 10/23/2017
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Provider Practice Location Address
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Address Line | CARR 113 KM 13.6 BO SAN ANTONIO
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City | QUEBRADILLAS
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State | PR
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Zip | 00678
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Country | US
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Telephone | 787-895-4203
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Fax | 787-895-4203
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Provider Business Mailing Address
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Address Line | PO BOX 894
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City | QUEBRADILLAS
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State | PR
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Zip | 00678-0894
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Country | US
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Telephone | 787-895-4203
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Fax | 787-895-4203
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Authorized Official
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Title or Position | MEDICAL TECHNOLOGIST -OWNER
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Name | OMAYRA VELEZ
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Credential | MEDICAL TECHNOLOGIST
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Telephone | 787-895-4203
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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 | 1168
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License Number State | PR
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