Provider Demographics
NPI:1598769861
Name:LABORATORIO CLINICO LOIZA VALLEY INC.
Entity Type:Organization
Organization Name:LABORATORIO CLINICO LOIZA VALLEY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:MILAGROS
Authorized Official - Last Name:SALICRUP
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-876-0430
Mailing Address - Street 1:PO BOX 937
Mailing Address - Street 2:
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-0937
Mailing Address - Country:US
Mailing Address - Phone:787-876-0430
Mailing Address - Fax:787-256-1836
Practice Address - Street 1:LOIZA VALLEY MALL
Practice Address - Street 2:BAUHINIA Z-977
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-876-0430
Practice Address - Fax:787-256-1836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR694291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR400111OtherPREFERRED HEALTH
PR00694OtherGLOBAL HEALTH PLAN
PR051290OtherLA CRUZ AZUL DE PR
PR20401OtherAMERICAN HEALTH INC.
PR30568OtherBLUE CROSS BLUE SHIELD
PR1424-3OtherASOCIACION DE MAESTROS
PR30568OtherTRIPLE SSS
PR6004296OtherACAA
PR=========OtherMAPFRE
PR=========OtherTRICARE
PR051290OtherLA CRUZ AZUL DE PR
PR30568OtherTRIPLE SSS
PR=========OtherFAMILY MEDICINE GROUP
PR20401OtherAMERICAN HEALTH INC.
PR400111OtherPREFERRED HEALTH
PR=========OtherGHI
PR6004296OtherACAA
PR=========OtherCIGNA HEALTHCARE
PR=========OtherEMPIRE HEALTHCHOICE
PR=========OtherFIRST PLUS