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General NPI Number Information
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NPI Number | 1659339661
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO CAMPO RICO ,INC.
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Dates
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Enumeration Date | 05/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 929 ROBERT O SANCHEZ VILELLA AVE. COUNTRY CLUB
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City | SAN JUAN
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State | PR
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Zip | 00924-2585
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Country | US
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Telephone | 787-762-0655
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Fax | 787-276-0677
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Provider Business Mailing Address
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Address Line | 929 AVE ROBERTO SANCHEZ VILELLA COUNTRY CLUB
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City | SAN JUAN
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State | PR
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Zip | 00924-2585
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Country | US
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Telephone |
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Fax | 787-276-0677
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. ADA E QUINONES
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Credential | MEDICAL TECHNOLOGIST
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Telephone | 787-762-0655
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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 | 786
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License Number State | PR
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