Provider Demographics
NPI:1992583959
Name:CB LABORATORY,LLC
Entity type:Organization
Organization Name:CB LABORATORY,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTA
Authorized Official - Prefix:
Authorized Official - First Name:ANABELL
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCANIO GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-948-6665
Mailing Address - Street 1:2 CALLE A
Mailing Address - Street 2:URB.GARCIA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-948-6665
Mailing Address - Fax:
Practice Address - Street 1:EDF.PASEO CARIBE
Practice Address - Street 2:15 AVE.LUIS MUNOZ RIVERA LOCAL 100C
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901
Practice Address - Country:US
Practice Address - Phone:787-645-4297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-20
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory