Provider Demographics
NPI:1467746867
Name:F.T. CLINICAL LABORATORIES,CSP
Entity Type:Organization
Organization Name:F.T. CLINICAL LABORATORIES,CSP
Other - Org Name:LABORATORIO CLINICO TORRES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ-FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-897-0263
Mailing Address - Street 1:PO BOX 143233
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-3233
Mailing Address - Country:US
Mailing Address - Phone:787-897-0263
Mailing Address - Fax:787-897-0263
Practice Address - Street 1:CARR 129 KM 21.8
Practice Address - Street 2:BO CALLEJONES
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669-0000
Practice Address - Country:US
Practice Address - Phone:787-897-0263
Practice Address - Fax:787-897-0263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR857291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR40D0882124OtherCLIA