Organization
LABORATORIO CLINICO PENA POBRE CSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMONA ROSADO ROSADO MT (LABORATORY DIRECTOR)
(787) 874-1698
Entity
Organization
Contact information
Practice address
ROAD 31 KM 13.0, BO PENA POBRE, NAGUABO, PR 00718
(787) 874-1698
(787) 874-1698
Mailing address
BH12 CALLE 33 VILLA UNIVERSITARIA, HUMACAO, PR 00791-4363
(787) 874-1698
(787) 874-1698
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
872
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
872
STATE LICENSE NUMBER
PR
Enumeration date
06/27/2005
Last updated
08/22/2020
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