Provider Demographics
NPI:1164867610
Name:LABORATORIO CLINICO QUINONES INC
Entity Type:Organization
Organization Name:LABORATORIO CLINICO QUINONES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YERIKA
Authorized Official - Middle Name:LILY
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:LCDA
Authorized Official - Phone:787-239-9140
Mailing Address - Street 1:TIERRA DEL SOL #125
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791
Mailing Address - Country:US
Mailing Address - Phone:787-239-9140
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 3 KM 85.6 BO. BUENA VISTA
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-239-9140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1283291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory