Provider Demographics
NPI:1467963900
Name:LCSA LLC
Entity Type:Organization
Organization Name:LCSA LLC
Other - Org Name:LABORATORIO CLINICO SAN ANTONIO
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL TECHNOLOGIST -OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OMAYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICAL TECHNOLOGIST
Authorized Official - Phone:787-895-4203
Mailing Address - Street 1:PO BOX 894
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678-0894
Mailing Address - Country:US
Mailing Address - Phone:787-895-4203
Mailing Address - Fax:787-895-4203
Practice Address - Street 1:CARR 113 KM 13.6
Practice Address - Street 2:BO SAN ANTONIO
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678
Practice Address - Country:US
Practice Address - Phone:787-895-4203
Practice Address - Fax:787-895-4203
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LCSA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-23
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1168291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory