Provider Demographics
NPI:1831251677
Name:LABORATORIO GARCIA CORPORATION
Entity type:Organization
Organization Name:LABORATORIO GARCIA CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARICELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:BSMT
Authorized Official - Phone:787-826-2360
Mailing Address - Street 1:PO BOX 540
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-0540
Mailing Address - Country:US
Mailing Address - Phone:787-826-2360
Mailing Address - Fax:787-826-6822
Practice Address - Street 1:67 CALLE 65 DE INFANTERIA
Practice Address - Street 2:
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-826-2360
Practice Address - Fax:787-826-6822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR514291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR40D0693411OtherCLIA
PR40D0693411OtherCLIA