Provider Demographics
NPI:1013180074
Name:LABORATORIO CLINICO RQ
Entity Type:Organization
Organization Name:LABORATORIO CLINICO RQ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-872-5942
Mailing Address - Street 1:496 CARR 112
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-6043
Mailing Address - Country:US
Mailing Address - Phone:787-872-5942
Mailing Address - Fax:787-872-5942
Practice Address - Street 1:496 CARR 112
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-6043
Practice Address - Country:US
Practice Address - Phone:787-872-5942
Practice Address - Fax:787-872-5942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR40D1079403291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory