Provider Demographics
NPI:1316050057
Name:LABORATORIO CLINICO SALINAS INC
Entity type:Organization
Organization Name:LABORATORIO CLINICO SALINAS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENTE
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAYDA
Authorized Official - Middle Name:I
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-824-2957
Mailing Address - Street 1:PO BOX 2308
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-2308
Mailing Address - Country:US
Mailing Address - Phone:787-824-2957
Mailing Address - Fax:787-824-3094
Practice Address - Street 1:BALDORIOTY STREET #59
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:PR
Practice Address - Zip Code:00751
Practice Address - Country:US
Practice Address - Phone:787-824-2957
Practice Address - Fax:787-824-3094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR391291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR031394Medicare ID - Type Unspecified