Provider Demographics
NPI:1205817533
Name:LABORATORIO NOCTURNO CAGUAS INC.
Entity Type:Organization
Organization Name:LABORATORIO NOCTURNO CAGUAS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL TECHNOLOGY
Authorized Official - Prefix:MRS
Authorized Official - First Name:LITZIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:MT ASCP
Authorized Official - Phone:787-744-2000
Mailing Address - Street 1:PO BOX 8307
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-8307
Mailing Address - Country:US
Mailing Address - Phone:787-744-2000
Mailing Address - Fax:787-743-4422
Practice Address - Street 1:CALLE BORGONA 3B-5 VILLA DEL REY
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726
Practice Address - Country:US
Practice Address - Phone:787-744-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR471291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR471OtherSTATE LIC
PR471OtherSTATE LIC