Provider Demographics
NPI:1235812801
Name:LABORATORIO CLINICO LA FE LLC
Entity Type:Organization
Organization Name:LABORATORIO CLINICO LA FE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:COREANO BURGOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-562-3211
Mailing Address - Street 1:39 CALLE LAGO CERRILLOS
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-2537
Mailing Address - Country:US
Mailing Address - Phone:787-562-3211
Mailing Address - Fax:
Practice Address - Street 1:LA FE PLAZA CARRETERA PR 510 KM. 2.10
Practice Address - Street 2:BARRIO SABANA LLANA
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-562-3211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory