Laboratorio Clinico Victoria Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

1176 Issued in PR

Legal business name

LABORATORIO CLINICO VICTORIA INC

Practice address

Carr Pr861 KM 3.3 Sector Alegria
Urb Miraflores
Bayamon, PR 00956

Phone

(787) 279-5900

Fax

(787) 279-5900

NPI assigned

Sep 30, 2008

Organization subpart

No

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

Authorized official

Name

Jolly Ortiz

Title

Director

Phone

(787) 614-2131

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1043460702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "00646",
            "telephone_number": "787-279-5900",
            "fax_number": "787-279-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR PR861 KM 3.3 SECTOR ALEGRIA",
            "address_2": "URB MIRAFLORES",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00956",
            "telephone_number": "787-279-5900",
            "fax_number": "787-279-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO VICTORIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-30",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "JOLLY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "787-614-2131"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Laboratorio Clinico Universitario
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• Laboratorio Clinico Y Bacteriologico Plaza Rio Hondo
• Laboratorio Clinico Y Referencia Olmo Inc.
• Laboratorio de Sueno Y Neurologia de PR
• Laboratorio del Sueno Inc

• Clinical Medical Laboratory in Bayamon, PR
• Providers in Bayamon, 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 Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.