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General NPI Number Information
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NPI Number | 1477560936
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO LAS TUNAS, INC.
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 07/10/2014
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Provider Practice Location Address
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Address Line | CARR 121 KM 3.6 URB LAS TUNAS
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City | SABANA GRANDE
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State | PR
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Zip | 00637
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Country | US
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Telephone | 787-873-0564
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Fax | 787-873-0564
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Provider Business Mailing Address
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Address Line | PO BOX 561679
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City | GUAYANILLA
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State | PR
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Zip | 00656-4119
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Country | US
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Telephone | 787-873-0564
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Fax | 787-873-0564
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DELIS ARZOLA
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Credential | MT, ASCP
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Telephone | 787-873-0564
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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 | 1104
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License Number State | PR
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