Provider Demographics
NPI:1750536595
Name:LABORATORIO CLINICO MARIELYS INC
Entity type:Organization
Organization Name:LABORATORIO CLINICO MARIELYS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-259-0134
Mailing Address - Street 1:P.O.BOX 3600
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00958
Mailing Address - Country:UM
Mailing Address - Phone:787-529-0134
Mailing Address - Fax:787-787-1940
Practice Address - Street 1:G52 CALLE 13
Practice Address - Street 2:SANTA MONICA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00957-1866
Practice Address - Country:US
Practice Address - Phone:787-529-0134
Practice Address - Fax:787-787-1940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory