Provider Demographics
NPI:1962727610
Name:CLINICAL LABORATORY SOLUTION, PSC
Entity type:Organization
Organization Name:CLINICAL LABORATORY SOLUTION, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YARITZI
Authorized Official - Middle Name:
Authorized Official - Last Name:APONTE
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-528-1086
Mailing Address - Street 1:CALLE ALONDRA 339
Mailing Address - Street 2:URB.LOS MONTE
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-398-9433
Mailing Address - Fax:787-883-8520
Practice Address - Street 1:CARR PR 2 KM30.4 PARCELAS CARMEN
Practice Address - Street 2:7-A BARRIO ESPINOSA
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692
Practice Address - Country:US
Practice Address - Phone:787-528-7083
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR10-027OtherCNC
PR62150OtherREGISTRO DE COMERCIANTES
4989OtherREGISTRO