Provider Demographics
NPI:1295860740
Name:LABORATORIO CLINICO TORRIVER
Entity Type:Organization
Organization Name:LABORATORIO CLINICO TORRIVER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ECHEVERRIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-764-4970
Mailing Address - Street 1:1688 CALLE PARANA
Mailing Address - Street 2:URB. EL CEREZAL
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-3144
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1688 CALLE PARANA
Practice Address - Street 2:URB. EL CEREZAL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-3144
Practice Address - Country:US
Practice Address - Phone:787-764-4970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR233291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR9260352OtherHUMANA
PRLA0256OtherPALIC
PRA-533OtherFIRST MEDICAL
PR101080OtherCRUZ AZUL
PR31493OtherTRIPLE-S
PR800069OtherMMM
PRLA0256OtherPALIC
PR800069OtherMMM
PRA-533OtherFIRST MEDICAL
PR=========OtherCOSVI
PR=========OtherSALUD DORADA
PR=========OtherCOSVI