Organization
MI LABORATORIO CLINICO COOP
Active
Organization
MI LABORATORIO CLINICO COOP
Active
Other names
MILABCOOP
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS A HENSON (PRESIDENTE)
(787) 608-4600
Entity
Organization
Contact information
Practice address
CARRETERA 115 KM 0.1, BARRIO ASOMANTE, AGUADA, PR 00602-3166
(787) 868-3339
(787) 868-3339
Mailing address
CALLE COLON # 118, AGUADA, PR 00602-3166
(787) 868-3339
(787) 868-3339
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
1169
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1169
LICENCIA DEPARTAMENTO DE SALUD
PR
01
—
14-077
CNC
PR
Enumeration date
03/18/2016
Last updated
03/18/2016
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