Provider Demographics
NPI:1114063062
Name:LABORATORIO SAN FRANCISCO DE ASIS INC
Entity Type:Organization
Organization Name:LABORATORIO SAN FRANCISCO DE ASIS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTORA
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAISY
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-868-8607
Mailing Address - Street 1:P.O. BOX 1529
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602
Mailing Address - Country:US
Mailing Address - Phone:787-868-8607
Mailing Address - Fax:
Practice Address - Street 1:AVE NATIVO ALERS PLAZA COPPELIA
Practice Address - Street 2:OFFICE 101
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-868-8607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR940291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory