Organization
CLINICAL MANAGEMENT GROUP INC
Active
Other names
laboratorio clinico y bact los angeles
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDGARDO L LOPEZ LCDO. (GENERAL SUPERVISOR)
(787) 743-2114
Entity
Organization
Contact information
Practice address
URB. PARADIS B-24 C LOPE FLORES, CAGUAS, PR 00725
(787) 743-2114
(787) 743-2114
Mailing address
PO BOX 4956 PMB 2190, CAGUAS, PR 00726-4956
(787) 746-2114
(787) 743-2114
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
415
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40D0658042
CLIA
PR
01
—
415
DEPTO SALUD
PR
Enumeration date
12/11/2006
Last updated
07/16/2021
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