Organization
LABORATORIO CLINICO Y BACTERIOLOGICO GENESIS II
Active
Parent organization
LABORATORIO CLINICO Y BACTERIOLOGICO GENESIS INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
LABORATORIO CLINICO Y BACTERIOLOGICO GENESIS INC.
Authorized official
MR. LUIS MANUEL CARRASQUILLO (MANAGER)
(787) 839-9393
Entity
Organization
Contact information
Practice address
CARR NUM 3, KM 122 HM 6, PATILLAS, PR 00723
(787) 839-9393
(787) 839-9344
Mailing address
PO BOX 986, PATILLAS, PR 00723-0986
(787) 839-9393
(787) 839-9344
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
1226
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031132
MEDICARE ID-TYPE UNSPECIFIED
PR
Enumeration date
08/25/2011
Last updated
08/25/2011
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