Provider Demographics
NPI:1124038583
Name:ALBITA S LAB CORPORATION
Entity Type:Organization
Organization Name:ALBITA S LAB CORPORATION
Other - Org Name:LAB. CLINICO RIVERA GONZALEZ II
Other - Org Type:Other Name
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MS
Authorized Official - First Name:ALBA
Authorized Official - Middle Name:IRIS
Authorized Official - Last Name:ARROYO
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICAL TECHNOLOGIST
Authorized Official - Phone:787-737-8130
Mailing Address - Street 1:APARTADO 1352
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-2322
Mailing Address - Country:US
Mailing Address - Phone:787-737-8130
Mailing Address - Fax:787-737-8130
Practice Address - Street 1:157 CALLE ANDRES ARUS RIVERA
Practice Address - Street 2:
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-2322
Practice Address - Country:US
Practice Address - Phone:787-737-8130
Practice Address - Fax:787-737-8130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR491291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7000006098Medicare UPIN
PR0031208Medicare PIN