Organization
CENTER DIAGNOSTIC LABORATORY,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILIA BERRIOS MT (SUPERVISOR)
(787) 781-2016
Entity
Organization
Contact information
Practice address
1251 AVE AMERICO MIRANDA, REPARTO METROPOLITANO, SAN JUAN, PR 00921-1619
(787) 781-2016
Mailing address
1251 AVE AMERICO MIRANDA, REPARTO METROPOLITANO, SAN JUAN, PR 00921-1619
(787) 781-2016
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
215
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0023
PALIC
PR
01
—
051349
LA CRUZ AZUL DE PR
PR
01
—
30608CE
TRIPLE S, INC
PR
01
—
400048
PREFERRED HEALTH
PR
01
—
6933
FIRST MEDICAL
PR
01
—
9210021
HUMANA
PR
Enumeration date
08/23/2005
Last updated
08/22/2020
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