Provider Demographics
NPI:1831286756
Name:CF- QUALITY MEDICAL LAB SERVICES
Entity Type:Organization
Organization Name:CF- QUALITY MEDICAL LAB SERVICES
Other - Org Name:LABORATORIO CLINICO LA FE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARICARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDONA
Authorized Official - Suffix:
Authorized Official - Credentials:LIC 3520
Authorized Official - Phone:787-837-6656
Mailing Address - Street 1:4 CALLE CAPELLAN
Mailing Address - Street 2:PATIO SENORIAL APDO 108
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730
Mailing Address - Country:US
Mailing Address - Phone:787-837-6656
Mailing Address - Fax:787-837-6656
Practice Address - Street 1:CARRETERA 510 KM2.9
Practice Address - Street 2:SECTOR SABANA LLANA
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:787-837-6656
Practice Address - Fax:787-837-6656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1088291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0031495Medicare PIN