Provider Demographics
NPI:1154845337
Name:LABORATORIO CLINICO JOBOS INC.
Entity Type:Organization
Organization Name:LABORATORIO CLINICO JOBOS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL TECNOLOGYST
Authorized Official - Prefix:
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:JEANNETTE
Authorized Official - Last Name:ROMAN VELAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-218-4536
Mailing Address - Street 1:259, CALLE ARIES
Mailing Address - Street 2:URB. DOMENECH
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662
Mailing Address - Country:US
Mailing Address - Phone:787-218-4536
Mailing Address - Fax:
Practice Address - Street 1:CARR 459,KM11.4
Practice Address - Street 2:BO. JOBOS
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-218-4536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-31
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory