MEDICARE: LABORATORIO CLINICO TORRIVER

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	233	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9260352	OTHER	PR	HUMANA
2	LA0256	OTHER	PR	PALIC
3	A-533	OTHER	PR	FIRST MEDICAL
4	101080	OTHER	PR	CRUZ AZUL
5	31493	OTHER	PR	TRIPLE-S
6	800069	OTHER	PR	MMM

General Provider Information

NPI Number	:	1295860740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LABORATORIO CLINICO TORRIVER

Provider Business Mailing Address
First Line	:	1688 CALLE PARANA
Second Line	:	URB. EL CEREZAL
City	:	SAN JUAN
State	:	PR
Zip	:	00926-3144
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1688 CALLE PARANA
Second Line	:	URB. EL CEREZAL
City	:	SAN JUAN
State	:	PR
Zip	:	00926-3144
Country	:	US
Telephone Number	:	787-764-4970
Fax Number	:

Authorized Official
Title or Position	:	SUPERVISOR
Name	:	OLGA J ECHEVERRIA
Credential	:
Telephone Number	:	787-764-4970

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	04/20/2008

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Directions to “LABORATORIO CLINICO TORRIVER ” Practice Location

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