Provider Demographics
NPI:1487172201
Name:LABORATORIO CLINICO NAZARRY INC
Entity type:Organization
Organization Name:LABORATORIO CLINICO NAZARRY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EDGARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CUEVAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-899-1483
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-0307
Mailing Address - Country:US
Mailing Address - Phone:787-515-5960
Mailing Address - Fax:787-808-1340
Practice Address - Street 1:45 CALLE JAVILLA
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4108
Practice Address - Country:US
Practice Address - Phone:787-892-3575
Practice Address - Fax:787-892-3575
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LABORATIORIO CLINICO NAZARRY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-31
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR440291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory