Provider Demographics
NPI:1154398113
Name:BORINQUEN LABORATORY SERVICES
Entity type:Organization
Organization Name:BORINQUEN LABORATORY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINA
Authorized Official - Middle Name:I
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MT/ASCP
Authorized Official - Phone:787-999-2797
Mailing Address - Street 1:PO BOX 14334
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00916-4334
Mailing Address - Country:US
Mailing Address - Phone:787-999-2797
Mailing Address - Fax:787-999-2798
Practice Address - Street 1:349 FELISA RINCON DE GAUTIER PASEO LAS CUMBRES
Practice Address - Street 2:SHOPPING CENTER SUITE 105
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-999-2797
Practice Address - Fax:787-999-2798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1061291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory