Provider Demographics
NPI:1780628453
Name:LABORATORIO CLINICO GARCIA INC
Entity Type:Organization
Organization Name:LABORATORIO CLINICO GARCIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NIVIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-851-1362
Mailing Address - Street 1:RUIZ BELVIS #21
Mailing Address - Street 2:PO BOX 609
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-0609
Mailing Address - Country:US
Mailing Address - Phone:787-851-1362
Mailing Address - Fax:787-851-1391
Practice Address - Street 1:21 CALLE RUIZ BELVIS
Practice Address - Street 2:
Practice Address - City:CABO ROJO
Practice Address - State:PR
Practice Address - Zip Code:00623-4029
Practice Address - Country:US
Practice Address - Phone:787-851-1362
Practice Address - Fax:787-851-1391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR348291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR38300Medicare ID - Type Unspecified