Provider Demographics
NPI:1588972095
Name:LABORATORIO CLINICO TRUJILLANO INC
Entity type:Organization
Organization Name:LABORATORIO CLINICO TRUJILLANO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LUGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-396-5809
Mailing Address - Street 1:URB EL CONQUISTADOR H16
Mailing Address - Street 2:AVE HERNAN CORTES
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-6417
Mailing Address - Country:US
Mailing Address - Phone:787-396-5809
Mailing Address - Fax:
Practice Address - Street 1:CENTRO COMERCIAL EL CONQUISTADOR
Practice Address - Street 2:CARR 175 KM 10.2
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-6417
Practice Address - Country:US
Practice Address - Phone:787-396-5809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-17
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory