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General NPI Number Information
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NPI Number | 1902913841
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO BORINQUEN-CIDRA PUEBLO
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 32 CALLE MUNOZ BARRIOS
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City | CIDRA
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State | PR
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Zip | 00739-3202
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Country | US
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Telephone | 787-739-6550
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Fax | 787-714-0534
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Provider Business Mailing Address
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Address Line | 2 CALLE BALDORIOTY
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City | CAGUAS
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State | PR
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Zip | 00725-2606
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Country | US
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Telephone | 787-744-0330
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Fax | 787-744-1717
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. KIMBERLY JEAN WHITLOCK
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Credential |
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Telephone | 787-744-0330
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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 | 176
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License Number State | PR
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