Provider Demographics
NPI:1043216781
Name:LABORATORIO CLINICO TURABO INC
Entity Type:Organization
Organization Name:LABORATORIO CLINICO TURABO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYRNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRINIDAD
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-743-8980
Mailing Address - Street 1:PO BOX 5638
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-5638
Mailing Address - Country:US
Mailing Address - Phone:787-743-8980
Mailing Address - Fax:787-258-3201
Practice Address - Street 1:VILLA CARMEN B 17 GAUTIER BENITEZ AVE.
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-743-8980
Practice Address - Fax:787-258-3201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR477291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR477OtherPR LICENSE
PR477OtherPR LICENSE