Provider Demographics
NPI:1134762867
Name:LABORATORIO CLINICO YANLUIS
Entity type:Organization
Organization Name:LABORATORIO CLINICO YANLUIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TECNOLOGA MEDICA
Authorized Official - Prefix:MRS
Authorized Official - First Name:YANITZA
Authorized Official - Middle Name:CRUZ
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:LICENCIADA
Authorized Official - Phone:787-204-1427
Mailing Address - Street 1:URB. VALLE ARRIBA CALLE ACASIA 197 COAMO PUERTO RICO
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769
Mailing Address - Country:US
Mailing Address - Phone:787-204-1427
Mailing Address - Fax:
Practice Address - Street 1:REPARTO EMANUELLI # 6 COAMO, PUERTO RICO 00769
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769
Practice Address - Country:US
Practice Address - Phone:787-204-1427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-25
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory