Organization
POTOMAR LABORATORIES INC.
Active
Other names
Laboratorio Clinico Santa Ana
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARGARITA GUTIERREZ BSMT (DIRECTOR)
(787) 883-1271
Entity
Organization
Contact information
Practice address
SANTA RITA H44 CALLE MARGINAL, VEGA ALTA, PR 00692
(787) 883-1271
(787) 883-1271
Mailing address
PO BOX 1950, BAYAMON, PR 00960-1950
(787) 883-1271
(787) 883-1271
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
LICENCE # 689
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40D0658222
CLIA CMS CERTIFICATE #
PR
01
—
LICENCE # 689
DPT. OF HEALTH LICENCE #
PR
Enumeration date
10/02/2006
Last updated
05/27/2008
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