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NPI Code Detail

MEDICARE: LABORATORIO CLINIC OMARIS INC

MEDICARE: LABORATORIO CLINIC OMARIS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory1053PR

General Provider Information

NPI Number : 1114922291
Entity Type Code : Organization
Provider Name (Legal Business Name) : LABORATORIO CLINIC OMARIS INC
Provider Business Mailing Address
First Line : CARR PR-2 KM 86 HM 2 CALLE MARGINAL
Second Line : 4
City : HATILLO
State : PR
Zip : 00659
Country : US
Telephone Number : 787-262-7071
Fax Number :
Provider Business Practice Location Address
First Line : CARR PR-2 KM 86 HM 2 CALLE MARGINAL
Second Line : 262 SUITE 4
City : HATILLO
State : PR
Zip : 00659
Country : US
Telephone Number : 787-262-7071
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MS. YOMARI BASCO
Credential : BS MT ASCP
Telephone Number : 787-262-7071
Provider Enumeration Date : 06/16/2005
Last Update Date : 01/07/2014

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Directions to “LABORATORIO CLINIC OMARIS INC ” Practice Location

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