Provider Demographics
NPI:1891906913
Name:USVI CLINICAL LABORATORIES INC.
Entity Type:Organization
Organization Name:USVI CLINICAL LABORATORIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUISA
Authorized Official - Middle Name:IDALIA
Authorized Official - Last Name:BECERRA
Authorized Official - Suffix:
Authorized Official - Credentials:BSMT, MHSA
Authorized Official - Phone:787-620-9095
Mailing Address - Street 1:1401 SUGAR STATE ROAD
Mailing Address - Street 2:SUITE NUMBER 3
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802
Mailing Address - Country:US
Mailing Address - Phone:340-774-8847
Mailing Address - Fax:340-777-8805
Practice Address - Street 1:1401 SUGAR STATE ROAD
Practice Address - Street 2:SUITE NUMBER 3
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-774-8847
Practice Address - Fax:340-777-8805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1-2012052-2005291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory