Provider Demographics
NPI:1083774731
Name:S & R LABORATORIO CLINICO CORP
Entity Type:Organization
Organization Name:S & R LABORATORIO CLINICO CORP
Other - Org Name:LABORATORIO CLINICO CANAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:W
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-812-3939
Mailing Address - Street 1:PO BOX 664
Mailing Address - Street 2:
Mailing Address - City:MERCEDITA
Mailing Address - State:PR
Mailing Address - Zip Code:00715-0664
Mailing Address - Country:US
Mailing Address - Phone:787-812-3939
Mailing Address - Fax:787-812-3931
Practice Address - Street 1:CARRETERA 132 KILOMETRO 2.1 BO. CANAS
Practice Address - Street 2:PLAZA GABRIELA
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728
Practice Address - Country:US
Practice Address - Phone:787-812-3939
Practice Address - Fax:787-812-3931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1117291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory