Provider Demographics
NPI:1407901101
Name:SERVI-LAB INC
Entity Type:Organization
Organization Name:SERVI-LAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTARATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:RAFAEL
Authorized Official - Last Name:VALENTIN
Authorized Official - Suffix:
Authorized Official - Credentials:ADM
Authorized Official - Phone:787-889-5730
Mailing Address - Street 1:PO BOX 1013
Mailing Address - Street 2:
Mailing Address - City:LUQUILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00773-1013
Mailing Address - Country:US
Mailing Address - Phone:787-889-5730
Mailing Address - Fax:787-889-8000
Practice Address - Street 1:109 CALLE FERNANDEZ GARCIA
Practice Address - Street 2:
Practice Address - City:LUQUILLO
Practice Address - State:PR
Practice Address - Zip Code:00773-2241
Practice Address - Country:US
Practice Address - Phone:787-889-6878
Practice Address - Fax:787-655-0011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR913291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory