Organization
LABORATORIO CLINICO UNIVERSITARIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARMEN ROSINA DE JESUS BS MT (LABORATORY DIRECTOR)
(787) 780-0611
Entity
Organization
Contact information
Practice address
EXT. HNAS DAVILA, CALLE 2, J-12, BAYAMON, PR 00959
(787) 780-0611
(787) 780-0611
Mailing address
EXT. HNAS DAVILA, CALLE 2, J-12, BAYAMON, PR 00959
(787) 780-0611
(787) 780-0611
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
420
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
420
PUERTO RICO LICENSE
PR
Enumeration date
04/24/2007
Last updated
08/22/2020
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