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NPI Code Detail

MEDICARE: LABORATORIO CLINICO NORTH MAIN

MEDICARE: LABORATORIO CLINICO NORTH MAIN
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 Laboratory679PR

General Provider Information

NPI Number : 1699791194
Entity Type Code : Organization
Provider Name (Legal Business Name) : LABORATORIO CLINICO NORTH MAIN
Provider Business Mailing Address
First Line : 2 CALLE BALDORIOTY
Second Line :
City : CAGUAS
State : PR
Zip : 00725-2606
Country : US
Telephone Number : 787-743-0330
Fax Number : 787-744-2588
Provider Business Practice Location Address
First Line : 31-15 AVE NORTH MAIN
Second Line :
City : BAYAMON
State : PR
Zip : 00961-4328
Country : US
Telephone Number : 787-798-6776
Fax Number : 787-269-1875
Authorized Official
Title or Position : DIRECTOR
Name : MS. KIMBERLY J WHITLOCK
Credential :
Telephone Number : 787-743-0330
Provider Enumeration Date : 07/15/2006
Last Update Date : 08/22/2020

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Directions to “LABORATORIO CLINICO NORTH MAIN ” Practice Location

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