Provider Demographics
NPI:1609026293
Name:SOUTH CARIBBEAN LABORATORY CORP
Entity Type:Organization
Organization Name:SOUTH CARIBBEAN LABORATORY CORP
Other - Org Name:LABORATORIO CLINICO PONCENO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:R
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-486-4554
Mailing Address - Street 1:QUINTAS DE MONSERRATE CALLE 2 D-7
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730
Mailing Address - Country:US
Mailing Address - Phone:787-486-4554
Mailing Address - Fax:787-259-5852
Practice Address - Street 1:CARR 2 KM 225.8
Practice Address - Street 2:LOCAL 26B
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00732
Practice Address - Country:US
Practice Address - Phone:787-486-4554
Practice Address - Fax:787-843-9000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-19
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory