Provider Demographics
NPI:1366775082
Name:LABORATORIO CLINICO ALONDRA
Entity type:Organization
Organization Name:LABORATORIO CLINICO ALONDRA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MT
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:YOLANDA
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-934-3562
Mailing Address - Street 1:PO BOX 1302
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-1302
Mailing Address - Country:US
Mailing Address - Phone:787-934-3562
Mailing Address - Fax:
Practice Address - Street 1:CALLE 2 F12 SANTA RITA
Practice Address - Street 2:
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692
Practice Address - Country:US
Practice Address - Phone:787-934-3562
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory