Provider Demographics
NPI:1396482410
Name:LABORATORIO CLINICO LA FAMILIA
Entity type:Organization
Organization Name:LABORATORIO CLINICO LA FAMILIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:MLS
Authorized Official - Phone:787-325-6548
Mailing Address - Street 1:323 PASEO GIBRALTAR
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-4786
Mailing Address - Country:US
Mailing Address - Phone:787-325-6548
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 113, KM 2.3
Practice Address - Street 2:BO. GUAYABOS
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-0066
Practice Address - Country:US
Practice Address - Phone:787-325-6548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory