Organization
LAB SUSUA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OMAYRA RODRIGUEZ MT (MEDICAL TECHNOLOGY)
(787) 836-5211
Entity
Organization
Contact information
Practice address
BO SUSUA ALTA CARR 368 KM 10.7, YAUCO, PR 00698-9688
(787) 856-5211
(787) 856-5211
Mailing address
HC 4 BOX 11824, YAUCO, PR 00698-9688
(787) 856-5211
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
05323
PR
291U00000X
Clinical Medical Laboratory
05576
PR
Other
Enumeration date
02/08/2013
Last updated
04/14/2014
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