Provider Demographics
NPI:1033396221
Name:LABORATORIO CLINICO CAPA INC
Entity Type:Organization
Organization Name:LABORATORIO CLINICO CAPA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOSQUES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-691-5360
Mailing Address - Street 1:PO BOX 1822
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676-1822
Mailing Address - Country:US
Mailing Address - Phone:787-877-6654
Mailing Address - Fax:
Practice Address - Street 1:STREET 111 KM 11.5 EDIFICIO PLAZA QUINTANA
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-877-6654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory