Organization
MEDLAB,CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNY RIVERA SERRANO MT LIC#6967 PR (PRESIDENT)
(787) 568-8833
Entity
Organization
Contact information
Practice address
PR 109 KM 26.4 INT 497 BO CULEBRINA, SAN SEBASTIAN, PR 00685
(787) 896-7298
(787) 896-7298
Mailing address
PO BOX 725, SAN SEBASTIAN, PR 00685-0725
(787) 896-7298
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
1307
PR
Other
Enumeration date
03/04/2014
Last updated
03/04/2014
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