MEDICARE: LABORATORIO CLINICO IRIZARRY GUASCH 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

General Provider Information

NPI Number	:	1962359471
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LABORATORIO CLINICO IRIZARRY GUASCH INC

Provider Business Mailing Address
First Line	:	URB MINIMA LA CARMEN CARR PR 3 KM 158.5 229 SUITE B
Second Line	:
City	:	SALINAS
State	:	PR
Zip	:	00751-2319
Country	:	US
Telephone Number	:	787-824-4333
Fax Number	:	787-899-1861

Provider Business Practice Location Address
First Line	:	URB MINIMA LA CARMEN CARR PR 3 KM 158.5 229 SUITE B
Second Line	:
City	:	SALINAS
State	:	PR
Zip	:	00751-2319
Country	:	US
Telephone Number	:	787-824-4333
Fax Number	:	787-899-1861

Authorized Official
Title or Position	:	SECRETARIA
Name	:	NILSA I IRIZARRY GUASCH
Credential	:
Telephone Number	:	787-899-7223

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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