Provider Demographics
NPI:1720423973
Name:LABORATORIO CLINICO CAMINO NUEVO INC
Entity Type:Organization
Organization Name:LABORATORIO CLINICO CAMINO NUEVO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, LAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-861-0100
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:MAUNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00707-0158
Mailing Address - Country:US
Mailing Address - Phone:787-861-0100
Mailing Address - Fax:787-861-3156
Practice Address - Street 1:CARRETERA PR 901 KM 3.6
Practice Address - Street 2:BARRIO CAMINO NUEVO
Practice Address - City:YABUCOA
Practice Address - State:PR
Practice Address - Zip Code:00767
Practice Address - Country:US
Practice Address - Phone:787-861-0100
Practice Address - Fax:787-861-3156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1282291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
40D2047664OtherCENTERS FOR MEDICARE & MEDICAID SERVICES (CMS)