Provider Demographics
NPI:1669546438
Name:LABORATORIO CLINICO ROLMAR RIVERA
Entity type:Organization
Organization Name:LABORATORIO CLINICO ROLMAR RIVERA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNERS
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-735-6584
Mailing Address - Street 1:PO BOX 1841
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-1841
Mailing Address - Country:US
Mailing Address - Phone:787-735-8245
Mailing Address - Fax:787-735-6584
Practice Address - Street 1:CALLE RAMON FLORES 113
Practice Address - Street 2:LABORATORIO CLINICO ROLMAR RIVERA INC
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:787-735-8245
Practice Address - Fax:787-735-8245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0031491Medicare PIN