Provider Demographics
NPI:1881414795
Name:LABORATORIO CLINICO EL YUNQUE LLC
Entity type:Organization
Organization Name:LABORATORIO CLINICO EL YUNQUE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL LABORATORY SCIENTIST (MLS)
Authorized Official - Prefix:
Authorized Official - First Name:JELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS ROLDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-377-3295
Mailing Address - Street 1:496 URB LOS ARBOLES PAJUIL A 29
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745
Mailing Address - Country:US
Mailing Address - Phone:787-377-3295
Mailing Address - Fax:
Practice Address - Street 1:MARGINAL CARR 3 KM 27.0, LOCAL #4, BO JIMENEZ
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00745
Practice Address - Country:US
Practice Address - Phone:787-377-3295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-15
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory