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General NPI Number Information
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NPI Number | 1528341773
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Entity Type | Organization
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Legal Business Name | I-LAB CORP
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 09/23/2011
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Provider Practice Location Address
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Address Line | CARR PR 14 KM. 30.0 CENTRO DE CONVENCIONES DE COAMO
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City | COAMO
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State | PR
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Zip | 00769
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Country | US
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Telephone | 787-825-7626
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Fax |
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Provider Business Mailing Address
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Address Line | 100 CARR 14 SUITE 1 CENTRO DE CONVENCIONES DE COAMO
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City | COAMO
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State | PR
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Zip | 00769-2981
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Country | US
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Telephone | 787-825-7626
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Fax |
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Authorized Official
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Title or Position | MEDICAL TECHNOLOGY
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Name | MRS. SUSAN MARTINEZ
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Credential |
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Telephone | 787-615-9102
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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 | PR
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