Provider Demographics
NPI:1609928548
Name:LABORATORIO CLINICO HERMANAS RODRIGUEZ INC
Entity Type:Organization
Organization Name:LABORATORIO CLINICO HERMANAS RODRIGUEZ INC
Other - Org Name:LABORATORIO CLINICO HERMANAS RODRIGUEZ II
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, MT
Authorized Official - Prefix:
Authorized Official - First Name:MYRNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-732-0467
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:
Mailing Address - City:AGUAS BUENAS
Mailing Address - State:PR
Mailing Address - Zip Code:00703-0307
Mailing Address - Country:US
Mailing Address - Phone:787-732-0467
Mailing Address - Fax:787-732-0210
Practice Address - Street 1:CARR 156 KM 49.4
Practice Address - Street 2:BO SUMIDERO
Practice Address - City:AGUAS BUENAS
Practice Address - State:PR
Practice Address - Zip Code:00703-0307
Practice Address - Country:US
Practice Address - Phone:787-732-0467
Practice Address - Fax:787-732-0210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory