MEDICARE: MB CLINICAL LABORATORIES EAST CORP.

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
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1275484784
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MB CLINICAL LABORATORIES EAST CORP.

Provider Business Mailing Address
First Line	:	PO BOX 476
Second Line	:
City	:	JUNCOS
State	:	PR
Zip	:	00777-0476
Country	:	US
Telephone Number	:	787-475-8731
Fax Number	:	787-734-1927

Provider Business Practice Location Address
First Line	:	159 CALLE ANDRES ARUS RIVERA W
Second Line	:
City	:	GURABO
State	:	PR
Zip	:	00778-2322
Country	:	US
Telephone Number	:	787-475-8731
Fax Number	:	787-734-1927

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSE CARLOS FLORES
Credential	:	MBA, BS, CT
Telephone Number	:	787-475-8731

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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