Provider Demographics
NPI:1407020936
Name:LABORATORIO CLINICO PASEO DEL RIO
Entity Type:Organization
Organization Name:LABORATORIO CLINICO PASEO DEL RIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL TECHNOLOGY
Authorized Official - Prefix:MRS
Authorized Official - First Name:YANIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLANO
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-653-7272
Mailing Address - Street 1:PO BOX 4960
Mailing Address - Street 2:PMB 497
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-4960
Mailing Address - Country:US
Mailing Address - Phone:787-653-7272
Mailing Address - Fax:787-653-5111
Practice Address - Street 1:CARRETERRA 183 KM 4.8
Practice Address - Street 2:BO TOMAS DE CASTRO
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-653-7272
Practice Address - Fax:787-653-5111
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LABORATORIO CLINICO ESPINO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-16
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR40D1077716291U00000X
PR40D2117212291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory