Organization
LABORATORIO CLINICO DEL BO. CORCOBADA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBINDRANATH PEREZ M.T. (PRESIDENT)
(787) 820-7402
Entity
Organization
Contact information
Practice address
493 RD K.M. 4.2 CORCOVADO WD, HATILLO, PR 00659
(787) 820-7402
(787) 820-7402
Mailing address
PO BOX 140267, ARECIBO, PR 00614-0267
(787) 820-7402
(787) 820-7402
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
1007
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40D0967204
CLIA NUMBER
PR
Enumeration date
03/20/2007
Last updated
12/16/2014
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