Provider Demographics
NPI:1710399522
Name:LABORATORIO CLINICO BIOMEDIC LLC
Entity Type:Organization
Organization Name:LABORATORIO CLINICO BIOMEDIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:ANDRES
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-200-9550
Mailing Address - Street 1:PO BOX 1203
Mailing Address - Street 2:SABANA SECA
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00951-1203
Mailing Address - Country:US
Mailing Address - Phone:787-200-9550
Mailing Address - Fax:888-384-1004
Practice Address - Street 1:CARR #2 KM 16 H 1
Practice Address - Street 2:BO CANDELARIA ARENA
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-0000
Practice Address - Country:US
Practice Address - Phone:787-200-9550
Practice Address - Fax:888-384-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1259291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory