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General NPI Number Information
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NPI Number | 1740329853
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO LAS ANTILLAS PSC
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 12/21/2010
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Provider Practice Location Address
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Address Line | EUGENIO SANCHEZ LOPEZ #7 SUR
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City | SAN LORENZO
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State | PR
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Zip | 00754
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Country | US
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Telephone | 787-736-2636
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Fax | 787-736-0677
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Provider Business Mailing Address
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Address Line | PO BOX 992
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City | SAN LORENZO
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State | PR
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Zip | 00754
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Country | US
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Telephone | 787-736-2636
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Fax | 787-736-0677
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MARIA T SALGUEIRO
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Credential | MT ASCP
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Telephone | 787-736-2636
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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 | 653
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License Number State | PR
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