MEDICARE: LABORATORIO CLINICO LUZMAR LLC LABORATORIO CLINICO AYMAT

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	607	PR

General Provider Information

NPI Number	:	1518082809
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LABORATORIO CLINICO LUZMAR LLC LABORATORIO CLINICO AYMAT

Provider Business Mailing Address
First Line	:	89 CIELO DORADO VILLAGE, CALLE CIELO ESMERALDA
Second Line	:
City	:	VEGA ALTA
State	:	PR
Zip	:	00692
Country	:	US
Telephone Number	:	787-788-2051
Fax Number	:	787-788-6150

Provider Business Practice Location Address
First Line	:	52 CALLE TREN
Second Line	:
City	:	CATANO
State	:	PR
Zip	:	00962-4874
Country	:	US
Telephone Number	:	787-788-2051
Fax Number	:	787-788-6150

Authorized Official
Title or Position	:	PROPIETARIO
Name	:	MR. JOSE R AYMAT AVILA
Credential	:	M. T. 2522
Telephone Number	:	787-788-2051

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	03/20/2026

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