Provider Demographics
NPI:1346685328
Name:LABORATORIO CLINICO IRIZARRY GUASCH INC
Entity type:Organization
Organization Name:LABORATORIO CLINICO IRIZARRY GUASCH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DUENA
Authorized Official - Prefix:MRS
Authorized Official - First Name:NILSA
Authorized Official - Middle Name:I
Authorized Official - Last Name:IRIZARRY GUASCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-899-7223
Mailing Address - Street 1:PO BOX 593
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-0593
Mailing Address - Country:US
Mailing Address - Phone:787-899-7223
Mailing Address - Fax:
Practice Address - Street 1:CARR PR 506 SOALR 3 LEGACY OFFICE PARK COTO LAUREL
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00780
Practice Address - Country:US
Practice Address - Phone:787-812-1233
Practice Address - Fax:787-812-1244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-06
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1184291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory