Provider Demographics
NPI:1003907346
Name:HIGH PROFILE LABORATORIES TESTING SERVICES LLC
Entity Type:Organization
Organization Name:HIGH PROFILE LABORATORIES TESTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIPOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-720-0767
Mailing Address - Street 1:PMB 355 AVE ESMERALDA 405
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-4457
Mailing Address - Country:US
Mailing Address - Phone:787-720-0760
Mailing Address - Fax:787-720-0763
Practice Address - Street 1:CARR 177 AVE LOMAS VERDES
Practice Address - Street 2:SUITE 103 EDIF PHOENIX CLINICA LOS AMERICAS
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-720-0760
Practice Address - Fax:787-720-0763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1081291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory