Organization
LABORATORIO CLINICO GUAYANILLENSE CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ILEANA MARIA PACHECO MT (DIRECTOR)
(787) 835-3209
Entity
Organization
Contact information
Practice address
MUNOZ RIVERA, #135, GUAYANILLA, PR 00656
(787) 835-3209
(787) 835-3283
Mailing address
MUNOZ RIVERA, #135, GUAYANILLA, PR 00656
(787) 835-3209
(787) 835-3283
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
0551
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0038216
MEDICARE PROVIDER
PR
01
—
40D0658094
CLIA NUMBER
PR
Enumeration date
10/03/2006
Last updated
12/01/2008
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