Provider Demographics
NPI:1083923106
Name:LABORATORIO CLINICO JOMYR, INC.
Entity Type:Organization
Organization Name:LABORATORIO CLINICO JOMYR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:MYRNALI
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA MELENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-340-7717
Mailing Address - Street 1:425 CARR. 693
Mailing Address - Street 2:PMB 212
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:939-777-0773
Mailing Address - Fax:787-957-1577
Practice Address - Street 1:CARR. 187 INT. 186 MEDIANIA BAJA
Practice Address - Street 2:
Practice Address - City:LOIZA
Practice Address - State:PR
Practice Address - Zip Code:00772
Practice Address - Country:US
Practice Address - Phone:787-957-5597
Practice Address - Fax:787-957-1577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-07
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory