Provider Demographics
NPI:1174766893
Name:LABORATORIO CLINICO L O P LAUREL INC
Entity type:Organization
Organization Name:LABORATORIO CLINICO L O P LAUREL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTORA DEL LABORATORIO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:I
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-748-0218
Mailing Address - Street 1:PO BOX 10529
Mailing Address - Street 2:CAPARRA HEIGHT STATION
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-0529
Mailing Address - Country:US
Mailing Address - Phone:787-748-0218
Mailing Address - Fax:787-748-4008
Practice Address - Street 1:CARR 506 SOLAR 3 LAGACY OFFICE PARK
Practice Address - Street 2:COTTO LAUREL
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00780
Practice Address - Country:US
Practice Address - Phone:787-748-0218
Practice Address - Fax:787-748-4008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-10
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1184291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory