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General NPI Number Information
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NPI Number | 1831286756
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Entity Type | Organization
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Legal Business Name | CF- QUALITY MEDICAL LAB SERVICES
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | CARRETERA 510 KM2.9 SECTOR SABANA LLANA
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City | JUANA DIAZ
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State | PR
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Zip | 00795
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Country | US
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Telephone | 787-837-6656
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Fax | 787-837-6656
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Provider Business Mailing Address
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Address Line | 4 CALLE CAPELLAN PATIO SENORIAL APDO 108
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City | PONCE
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State | PR
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Zip | 00730
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Country | US
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Telephone | 787-837-6656
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Fax | 787-837-6656
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARICARMEN CARDONA
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Credential | LIC 3520
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Telephone | 787-837-6656
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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 | 1088
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License Number State | PR
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