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General NPI Number Information
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NPI Number | 1619435088
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO IRIZARRY GUASCH INC
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Dates
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Enumeration Date | 03/05/2019
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Last Update Date | 03/05/2019
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Provider Practice Location Address
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Address Line | 42 CALLE DR VEVE
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City | SAN GERMAN
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State | PR
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Zip | 00683-4052
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Country | US
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Telephone | 787-892-5881
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Fax | 787-892-5881
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Provider Business Mailing Address
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Address Line | PO BOX 593
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City | LAJAS
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State | PR
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Zip | 00667-0593
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Country | US
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Telephone | 787-899-7223
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Fax |
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Authorized Official
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Title or Position | SECRETARIA
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Name | MRS. NILSA I IRIZARRY GUASCH
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Credential |
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Telephone | 787-899-7223
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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 |
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