Provider Demographics
NPI:1821368473
Name:LABORATORIO CLINICO NAZARETH INC
Entity Type:Organization
Organization Name:LABORATORIO CLINICO NAZARETH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEANETE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-884-5252
Mailing Address - Street 1:PO BOX 2315
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-2315
Mailing Address - Country:US
Mailing Address - Phone:787-884-5252
Mailing Address - Fax:787-884-5252
Practice Address - Street 1:CARR # 2 KM 46.4 BARRIO CAMPO ALEGRE
Practice Address - Street 2:EDIFICIO LAS VEGAS
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-884-5252
Practice Address - Fax:787-884-5252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1103291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory