Organization
WAXALI INC
Active
Parent organization
WAXALI INC
Other names
Laboratorio Clinico Isla Centro Cedro Arriba
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAXALI INC
Authorized official
MR. JOSE L COLLAZO ROSADO MT (PRESIDENT OWNER)
(787) 869-1111
Entity
Organization
Contact information
Practice address
CARRETERA 803 KM 10.3, BARRIO CEDRO ARRIBA, NARANJITO, PR 00719-9722
(787) 869-1111
(787) 869-2318
Mailing address
HC 72 BOX 3954, NARANJITO, PR 00719-8771
(787) 869-1111
(787) 869-2318
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
776
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40D0658158
CLIA
PR
01
—
776
STATE
PR
Enumeration date
09/20/2006
Last updated
09/29/2010
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