Provider Demographics
NPI:1851599708
Name:QJP LABORATORY SERVICE, INC.
Entity Type:Organization
Organization Name:QJP LABORATORY SERVICE, INC.
Other - Org Name:LABORATORIO CLINICO LOS PINOS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL TECHNOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:QUIOMARI
Authorized Official - Middle Name:J
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-201-7794
Mailing Address - Street 1:PO BOX 1064
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-1064
Mailing Address - Country:US
Mailing Address - Phone:787-881-2828
Mailing Address - Fax:787-881-2828
Practice Address - Street 1:ROAD 2 KM 67 HM 7 INT SANTANA
Practice Address - Street 2:ZONA INDUSTRIAL
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-881-2828
Practice Address - Fax:878-881-2828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1123291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory