Provider Demographics
NPI:1962537647
Name:HEALTH LABORATORIES SERVICES INC
Entity type:Organization
Organization Name:HEALTH LABORATORIES SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYRTA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ DE VICTORIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-727-6429
Mailing Address - Street 1:PO BOX 3310
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-3310
Mailing Address - Country:US
Mailing Address - Phone:787-727-6429
Mailing Address - Fax:787-727-6429
Practice Address - Street 1:2426 CALLE LOIZA
Practice Address - Street 2:PUNTA LAS MARIAS
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00913-4731
Practice Address - Country:US
Practice Address - Phone:787-727-6429
Practice Address - Fax:787-727-6429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR833291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR660487502OtherCOSVI MED PROV #
PR051622OtherCRUZ AZUL PROV #
PR20115BOtherPMC PROV #
PR8462OtherIMC PROVIDER #
PRLA-0010OtherPALIC PROV #
PR800056OtherMMM HEALTHCARE PROV #
PR400196OtherUTI PRFERRED PROV #
PR20098OtherAMERICAN HEALTH PROV #
PR31035PUOtherTRIPLE S PROV #
PR9790022OtherHUMANA PROV #
PR=========1OtherCOSVI PROV #
PR20115BOtherPMC PROV #
PR31035PUOtherTRIPLE S PROV #
PR9790022OtherHUMANA PROV #
PR=========OtherCIGNA PROV #
PR=========OtherMAPFRE MED PROV #
PR=========-03OtherFIRST PLUS MED PROV #
PR=========3OtherMCS PROV #
PR0030872Medicare ID - Type UnspecifiedPROVIDER NUMBER