MEDICARE: LABORATORIO CLINICO ALEJANDRINO, 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
1	291U00000X	Clinical Medical Laboratory	882	PR

General Provider Information

NPI Number	:	1649238650
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LABORATORIO CLINICO ALEJANDRINO, INC.

Provider Business Mailing Address
First Line	:	310 AVE LOMAS VERDES
Second Line	:	SUITE 203
City	:	SAN JUAN
State	:	PR
Zip	:	00927-6638
Country	:	US
Telephone Number	:	787-764-4593
Fax Number	:	787-276-0677

Provider Business Practice Location Address
First Line	:	310 LOMAS VERDES AVE.
Second Line	:	SUITE 203
City	:	SAN JUAN
State	:	PR
Zip	:	00927-6638
Country	:	US
Telephone Number	:	787-764-4593
Fax Number	:	787-276-0677

Authorized Official
Title or Position	:	CLINICAL CONSULTANT
Name	:	DR. ARNALDO R QUINONES
Credential	:	MD
Telephone Number	:	787-764-4593

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	08/22/2020

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