Organization
WAXALI INC
Active
Parent organization
WAXALI INC
Other names
Laboratorio Clinico Isla Centro Barranquitas
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAXALI INC
Authorized official
MR. JOSE L COLLAZO ROSADO MT (PRESIDENT OWNER)
(787) 869-1111
Entity
Organization
Contact information
Practice address
17 CALLE MUNOZ RIVERA, SUITE 1, BARRANQUITAS, PR 00794-1755
(787) 857-2246
Mailing address
HC 72 BOX 3954, NARANJITO, PR 00719-8771
(787) 869-1111
(787) 869-2318
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
232
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10-113
CNC
PR
01
—
232
STATE LICENCE
PR
01
—
40D0667627
CLIA
—
Enumeration date
09/16/2010
Last updated
09/23/2010
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