Provider Demographics
NPI:1316928559
Name:LABORATORIO CLINICO NAZARRY INC
Entity type:Organization
Organization Name:LABORATORIO CLINICO NAZARRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENCARGADO
Authorized Official - Prefix:
Authorized Official - First Name:EDGARDO
Authorized Official - Middle Name:L
Authorized Official - Last Name:CUEVAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-899-1483
Mailing Address - Street 1:HC 1 BOX 3401
Mailing Address - Street 2:
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601-9535
Mailing Address - Country:US
Mailing Address - Phone:787-899-1483
Mailing Address - Fax:787-899-1483
Practice Address - Street 1:CALLE 65 DE INTANTERIA #47
Practice Address - Street 2:PLAZA DEL VALLE STE 006
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667
Practice Address - Country:US
Practice Address - Phone:787-899-1483
Practice Address - Fax:787-899-1483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-07
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR440OtherHEALTH DEPT-2ND LOCATION
PR335OtherHEALTH DEPT-1ST LOCATION
PR335OtherHEALTH DEPT-1ST LOCATION