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General NPI Number Information
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NPI Number | 1720172026
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO RAUL DIAZ
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | LABORATORIO CLINICO RAUL DIAZ AVE. JESUS T. PINERO 265
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City | SAN JUAN
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State | PR
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Zip | 00927
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Country | US
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Telephone | 787-758-0120
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Fax | 787-250-8123
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Provider Business Mailing Address
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Address Line | PO BOX 22321 UPR STATION
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City | SAN JUAN
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State | PR
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Zip | 00931-2321
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Country | US
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Telephone | 787-758-0120
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Fax | 787-250-8123
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Authorized Official
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Title or Position | OWNER
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Name | MR. RAUL DIAZ PINEIRO
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Credential |
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Telephone | 787-758-0120
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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 | 617
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License Number State | PR
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