Provider Demographics
NPI:1740315423
Name:HEALTH LABORATORIES SERVICES INC
Entity type:Organization
Organization Name:HEALTH LABORATORIES SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYRTA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ DE VICTORIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-762-4786
Mailing Address - Street 1:PO BOX 3310
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-3310
Mailing Address - Country:US
Mailing Address - Phone:787-755-5180
Mailing Address - Fax:787-755-5180
Practice Address - Street 1:869 CARR 876
Practice Address - Street 2:NUESTRA SENORA DE LOURDES
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-3813
Practice Address - Country:US
Practice Address - Phone:787-755-5180
Practice Address - Fax:787-755-5180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR677291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR800055OtherMMM HEALTHCARE PROV#
PR048755402OtherCOSVI PROVIDER #
PR20115AOtherPMC PROV #
PR30561CEOtherTRIPLE S PROV #
PR8462OtherIMC PROV #
PR400060OtherUTI PREFERRED PROV #
PR7600017OtherHUMANA PROV #
PR660487501OtherCOSVI MED PROV #
PRL0010OtherPALIC PROV #
PR051264OtherCRUZ AZUL PROV #
PR40677OtherCIGNA EXCLUSIVE #
PR8462OtherIMC PROV #
PR=========OtherMCS REFORMA PROV #
PR30561CEOtherTRIPLE S PROV #
PR7600017OtherHUMANA PROV #
PRL0010OtherPALIC PROV #
PR=========OtherMAPFRE MED PROV #
PR40677OtherCIGNA EXCLUSIVE #
PR=========-02OtherFIRST PLUS MED PROV #
PR660487501OtherCOSVI MED PROV #