Provider Demographics
NPI:1376860635
Name:LABORATORIO CLINICO BARRAZAS INC
Entity Type:Organization
Organization Name:LABORATORIO CLINICO BARRAZAS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MT
Authorized Official - Prefix:
Authorized Official - First Name:YADITH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-776-1300
Mailing Address - Street 1:HC 645 BOX 6344
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-9749
Mailing Address - Country:US
Mailing Address - Phone:787-509-0729
Mailing Address - Fax:
Practice Address - Street 1:ROAD 853 KM 11.4
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-776-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-27
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1216291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory