Organization
LABORATORIO TERESITA LLC
Active
Other names
LABORATORIO TERESITA
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA ZAMARA GONZALEZ (PRESIDENT)
(787) 675-0112
Entity
Organization
Contact information
Practice address
CARR 175 KM10.2 CENTRO COMERCIAL EL CONQUISTADOR, TRUJILLO ALTO, PR 00977
(787) 903-5305
Mailing address
CALLE CUARZO A23 MIRABELLA VILLAGE, BAYAMON, PR 00961
(787) 675-0112
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1264
LICIENCIA LAB
PR
01
—
40D2037492
CLIA
PR
Enumeration date
03/15/2022
Last updated
03/15/2022
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