Potomar Laboratories Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

LICENCE # 689 Issued in PR

Legal business name

POTOMAR LABORATORIES INC.

Doing business as

Laboratorio Clinico Santa Ana

Practice address

Santa Rita H44 Calle Marginal
Vega Alta, PR 00692

Phone

(787) 883-1271

Fax

(787) 883-1271

NPI assigned

Oct 2, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Margarita Gutierrez, BSMT

Title

Director

Phone

(787) 883-1271

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Laboratorio Clinico Santa Ana Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1023101516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1950",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009601950",
            "telephone_number": "787-883-1271",
            "fax_number": "787-883-1271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SANTA RITA H44 CALLE MARGINAL",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "00692",
            "telephone_number": "787-883-1271",
            "fax_number": "787-883-1271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAR LABORATORIES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "MARGARITA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "787-883-1271",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BSMT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "LICENCE # 689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPT. OF HEALTH LICENCE #",
            "identifier": "LICENCE # 689",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA CMS CERTIFICATE #",
            "identifier": "40D0658222",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laboratorio Clinico Santa Ana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Vega Alta, PR
• Providers in Vega Alta, PR by specialty
• Clinical Medical Laboratory in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.