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General NPI Number Information
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NPI Number | 1881414795
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO EL YUNQUE LLC
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | MARGINAL CARR 3 KM 27.0, LOCAL #4, BO JIMENEZ
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City | RIO GRANDE
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State | PR
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Zip | 00745
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Country | US
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Telephone | 787-377-3295
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Fax |
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Provider Business Mailing Address
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Address Line | 496 URB LOS ARBOLES PAJUIL A 29
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City | RIO GRANDE
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State | PR
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Zip | 00745
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Country | US
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Telephone | 787-377-3295
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Fax |
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Authorized Official
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Title or Position | MEDICAL LABORATORY SCIENTIST (MLS)
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Name | JELISSA VARGAS ROLDAN
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Credential |
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Telephone | 787-377-3295
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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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