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General NPI Number Information
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NPI Number | 1841377058
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Entity Type | Organization
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Legal Business Name | TEJAV SANTURCE LAB SERVICES, INC.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 12/15/2009
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Provider Practice Location Address
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Address Line | 1427 AVE FERNANDEZ JUNCOS
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City | SAN JUAN
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State | PR
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Zip | 00909-2658
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Country | US
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Telephone | 787-763-3545
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Fax | 787-724-0545
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Provider Business Mailing Address
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Address Line | PO BOX 360632
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City | SAN JUAN
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State | PR
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Zip | 00936-0632
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Country | US
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Telephone | 787-763-3545
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Fax | 787-724-0545
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Authorized Official
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Title or Position | LABORATORY DIRECTOR PRESIDENT
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Name | MRS. TERESITA ORTIZ
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Credential | M.T.
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Telephone | 787-763-3545
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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 | 00910
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License Number State | PR
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