Provider Demographics
NPI:1770955411
Name:JARU LAB MANAGEMENT CORP
Entity type:Organization
Organization Name:JARU LAB MANAGEMENT CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEFINO
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-458-9015
Mailing Address - Street 1:576 CALLE CESAR GONZALEZ
Mailing Address - Street 2:ADLER MEDICAL PLAZA OFI 101-C
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3756
Mailing Address - Country:US
Mailing Address - Phone:787-766-1464
Mailing Address - Fax:787-773-0766
Practice Address - Street 1:576 CESAR GONZALEZ OFI 101C
Practice Address - Street 2:ADLER MEDICAL PLAZA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3757
Practice Address - Country:US
Practice Address - Phone:787-766-1464
Practice Address - Fax:787-773-0766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-21
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR711291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory