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General NPI Number Information
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NPI Number | 1942496856
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO VALENCIANO DEL ESTE INC
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 09/25/2007
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Provider Practice Location Address
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Address Line | 189 ROAD AMERICAN PLAZA
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City | CAGUAS
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State | PR
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Zip | 00725
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Country | US
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Telephone | 787-743-2580
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Fax | 787-743-2580
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Provider Business Mailing Address
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Address Line | 243 LA SERRANIA
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City | CAGUAS
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State | PR
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Zip | 00725-1808
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Country | US
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Telephone | 787-713-0922
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Fax | 787-743-2580
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARIE CARMEN COLON
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Credential | M.T.
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Telephone | 787-743-2580
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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 | 1134
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License Number State | PR
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