Provider Demographics
NPI:1578935631
Name:LABORATORIO CLINICO CDT DR. ARNALDO J GARCIA
Entity Type:Organization
Organization Name:LABORATORIO CLINICO CDT DR. ARNALDO J GARCIA
Other - Org Name:LABORATORIO CLINICO CDT DR ARNALDO J GARCIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTORDIRECTOR/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:V
Authorized Official - Last Name:CLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-480-3838
Mailing Address - Street 1:PO BOX 21405
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00928-1405
Mailing Address - Country:US
Mailing Address - Phone:787-480-3876
Mailing Address - Fax:787-977-8401
Practice Address - Street 1:CALLE FLOR ANTILLANA RESIDENCIAL LUIS LLORENS TORRES
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1405
Practice Address - Country:US
Practice Address - Phone:787-480-4900
Practice Address - Fax:787-977-8401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR678291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR037899900Medicaid