Provider Demographics
NPI:1912039744
Name:LABORATORIO CLINICO DEL MAR II INC.
Entity Type:Organization
Organization Name:LABORATORIO CLINICO DEL MAR II INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MELENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-406-1521
Mailing Address - Street 1:BOX 2221
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-2221
Mailing Address - Country:US
Mailing Address - Phone:787-807-3423
Mailing Address - Fax:787-807-3423
Practice Address - Street 1:CARR #2 KM 43.5 BO. ALGARROBO
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-0000
Practice Address - Country:US
Practice Address - Phone:787-807-3423
Practice Address - Fax:787-807-3423
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LABORATORIO CLINICO DEL MAR L.L.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1034291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory