Provider Demographics
NPI:1760510721
Name:LABORATORIO CLINICO RAMIREZ
Entity Type:Organization
Organization Name:LABORATORIO CLINICO RAMIREZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOPEZ-ALMA
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-899-3670
Mailing Address - Street 1:20 CALLE 65 INFANTERIA
Mailing Address - Street 2:SUITE2
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667
Mailing Address - Country:US
Mailing Address - Phone:787-899-2163
Mailing Address - Fax:
Practice Address - Street 1:20 AVE 65 INFANTERIA
Practice Address - Street 2:SUITE2
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667
Practice Address - Country:US
Practice Address - Phone:787-899-2163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR830291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR30862Medicare ID - Type UnspecifiedPROVIDER ID