Provider Demographics
NPI:1487904223
Name:LABORATORIO CLINICO CUBUY INC
Entity type:Organization
Organization Name:LABORATORIO CLINICO CUBUY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:MIRNALY
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-886-7755
Mailing Address - Street 1:URB. GRAND PALM II 247
Mailing Address - Street 2:CALLE ALMENDRO
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-886-7755
Mailing Address - Fax:787-886-7755
Practice Address - Street 1:URB. GRAND PALM II 247
Practice Address - Street 2:CALLE ALMENDRO
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-886-7755
Practice Address - Fax:787-886-7755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory