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General NPI Number Information
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NPI Number | 1588006704
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO HORMIGUEROS LLC
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Dates
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Enumeration Date | 07/30/2013
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 27 CALLE PERAL N STE 107
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City | MAYAGUEZ
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State | PR
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Zip | 00680-4820
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Country | US
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Telephone | 787-832-4376
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Fax | 787-827-9300
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Provider Business Mailing Address
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Address Line | PO BOX 57
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City | HORMIGUEROS
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State | PR
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Zip | 00660-0057
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Country | US
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Telephone | 787-832-4376
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Fax | 787-827-9300
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Authorized Official
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Title or Position | CEO
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Name | TANIA RODRIGUEZ
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Credential | DRA
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Telephone | 939-246-5312
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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 | 478
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License Number State | PR
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