Provider Demographics
NPI:1912515628
Name:LABORATORIO CLINICO VAZQUEZ,INC
Entity Type:Organization
Organization Name:LABORATORIO CLINICO VAZQUEZ,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:VAZQUEZ OSORIO
Authorized Official - Suffix:
Authorized Official - Credentials:MLS(ASCP)
Authorized Official - Phone:787-910-1376
Mailing Address - Street 1:BO PUEBLO 197 GUAYACAN
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CARR. 681 KM 2.4 BO. ISLOTE SECTOR JAREALITOS
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-910-1376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-20
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical TechnologistGroup - Single Specialty