Organization
LABORATORIO CLINICO DEL BO. CORCOBADA, INC.
Active
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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