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General NPI Number Information
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NPI Number | 1861043960
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Entity Type | Organization
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Legal Business Name | RW LAB LLC
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Dates
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Enumeration Date | 09/20/2019
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | CARR. PR 173, KM6, HM5, SECTOR SAN JOSE, BO. RABANAL
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City | CIDRA
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State | PR
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Zip | 00739
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Country | US
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Telephone | 787-520-7390
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Fax | 787-520-7108
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Provider Business Mailing Address
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Address Line | P.O. BOX 459
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City | CIDRA
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State | PR
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Zip | 00739
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Country | US
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Telephone | 787-520-7390
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Fax | 787-520-7108
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Authorized Official
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Title or Position | ADMINISTRATOR, PRESIDENT
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Name | DR. ROBERT RIVERA QUILES
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Credential | MD
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Telephone | 787-603-2378
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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 |
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License Number State |
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