Organization
LABORATORIO CLINICO COUNTRY CLUB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EUGENIO ROMAN (ADMINISTRATOR)
(787) 748-4102
Entity
Organization
Contact information
Practice address
758 ROBERTO SANCHEZ VILELLA STREET, COUNTRY CLUB, SAN JUAN, PR 00926
(787) 748-2580
(787) 257-1110
Mailing address
1353 AVE LUIS VIGOREAUX, PMB 364, GUAYNABO, PR 00966-2715
(787) 748-2580
(787) 257-1110
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
147
PR
Other
Enumeration date
02/10/2015
Last updated
02/10/2015
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