NPIMap

Organization Active NPI

Laboratorio Clinico del Sureste, Inc

  • Clinical Medical Laboratory
  • Yabucoa, PR
National Provider Identifier
1063634483
Registry record updated Apr 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
569 Issued in PR
Legal business name
LABORATORIO CLINICO DEL SURESTE, INC
Practice address
Calle Saturinino Rodriguez 22
Yabucoa, PR 00767-1340
Phone
(787) 893-2340
Fax
(787) 893-1112
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2009

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

Authorized official

Name
Mrs. Yanire Castro
Title
Laboratory Supervisor
Phone
(787) 893-2340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 569 PR Primary

Addresses

Primary practice location

Calle Saturinino Rodriguez 22
Yabucoa, PR 00767-1340

Mailing address

P O Box 1340
Yabucoa, PR 00767-1340
Phone (787) 893-2340

Other names 1

  • LABORATORIO CLINICO COLON #2 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070607000463 PR Part B Supplier - Independent Clinical Laboratory 7810095353 Practice locations: Yabucoa, PR

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Lab Clinico del Sureste Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238544000000",
    "number": "1063634483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 1340",
            "city": "YABUCOA",
            "state": "PR",
            "postal_code": "007671340",
            "telephone_number": "787-893-2340",
            "fax_number": "787-893-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE SATURININO RODRIGUEZ 22",
            "city": "YABUCOA",
            "state": "PR",
            "postal_code": "007671340",
            "telephone_number": "787-893-2340",
            "fax_number": "787-893-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO DEL SURESTE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2009-04-01",
        "status": "A",
        "authorized_official_last_name": "CASTRO",
        "authorized_official_first_name": "YANIRE",
        "authorized_official_title_or_position": "LABORATORY SUPERVISOR",
        "authorized_official_telephone_number": "787-893-2340",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LABORATORIO CLINICO COLON #2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yabucoa, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; 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.