Provider Demographics
NPI:1841052933
Name:LABORATORIO CLINICO RQ, LLC
Entity type:Organization
Organization Name:LABORATORIO CLINICO RQ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:ANTONIO
Authorized Official - Last Name:CARDONA-QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-209-1599
Mailing Address - Street 1:496 CARR 112
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-6043
Mailing Address - Country:US
Mailing Address - Phone:787-872-5942
Mailing Address - Fax:
Practice Address - Street 1:CARR 112 KM 5.3
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-6043
Practice Address - Country:US
Practice Address - Phone:787-872-5942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory