=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487688743
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LABORATORIO CLINICO BIO TECH INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2006
-----------------------------------------------------
Last Update Date | 04/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CALLE 401 BLQ 139 # 12 4TA EXT. VILLA CAROLINA
-----------------------------------------------------
City | CAROLINA
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00985-0849
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-768-7832
-----------------------------------------------------
Fax | 787-769-5323
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 849
-----------------------------------------------------
City | CANOVANAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00729-0849
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-421-7315
-----------------------------------------------------
Fax | 787-769-5323
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. HARRY JOSE ABRANTE
-----------------------------------------------------
Credential | ENGINEER
-----------------------------------------------------
Telephone | 787-421-7315
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number | 1102
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------