Organization
PATHOLOGY LAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSCAR TRUJILLO M.D. (PRESIDENTE)
(787) 834-8202
Entity
Organization
Contact information
Practice address
55 CALLE DR BASORA N, SUITE 206, MAYAGUEZ, PR 00680-4810
(787) 834-8202
(787) 751-8286
Mailing address
PO BOX 194800, SAN JUAN, PR 00919-4800
(787) 751-8286
(787) 751-8286
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
6222
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40D0723878
CLIA
PR
Enumeration date
04/07/2017
Last updated
04/07/2017
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