Provider Demographics
NPI:1598443277
Name:MB CLINICAL LABORATORIES EAST CORP.
Entity Type:Organization
Organization Name:MB CLINICAL LABORATORIES EAST CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:MBA,BS,CT
Authorized Official - Phone:787-475-8731
Mailing Address - Street 1:PO BOX 476
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-0476
Mailing Address - Country:US
Mailing Address - Phone:787-475-8731
Mailing Address - Fax:
Practice Address - Street 1:2 CALLE INTENDENTE RAMIREZ
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-2631
Practice Address - Country:US
Practice Address - Phone:787-744-1370
Practice Address - Fax:787-744-1370
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MB CLINICAL LABORATORIES EAST CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-11
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory