Laboratorio Clinico Sagrado Corazon, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

496 Issued in PR

Legal business name

LABORATORIO CLINICO SAGRADO CORAZON, INC

Practice address

370 Ave San Claudio
Urb. Sagrado Corazon
San Juan, PR 00926-4107

Phone

(787) 761-5193

Fax

(787) 755-4902

NPI assigned

Jul 19, 2005

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Maria T Lebron, BSMT

Title

Clinical Laboratory Director

Phone

(787) 761-5193

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1073512315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 AVE SAN CLAUDIO STE 199",
            "address_2": "URB. SAGRADO CORAZON",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009264107",
            "telephone_number": "787-761-5193",
            "fax_number": "787-755-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 AVE SAN CLAUDIO",
            "address_2": "URB. SAGRADO CORAZON",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009264107",
            "telephone_number": "787-761-5193",
            "fax_number": "787-755-4902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO SAGRADO CORAZON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "LEBRON",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CLINICAL LABORATORY DIRECTOR",
        "authorized_official_telephone_number": "787-761-5193",
        "authorized_official_credential": "BSMT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNATIONAL MEDICAL CAR",
            "identifier": "7726",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNION INDEPENDIENTE TRABA",
            "identifier": "400134",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA INSURANCE , INC",
            "identifier": "9260064",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S, INC",
            "identifier": "31220",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA HEALTH PLANS, INC",
            "identifier": "9260064",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNION INDEPENDIENTE AUTEN",
            "identifier": "LB00496",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA CRUZ AZUL DE PR",
            "identifier": "050726",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laboratorio Clinico Puerto Rico Holding, LLC
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• Laboratorio Clinico Puerto Rico Holding,LLC
• Laboratorio Clinico Raul Diaz
• Laboratorio Clinico Risan, Inc.
• Laboratorio Clinico San Juan Inc
• Laboratorio Clinico Torriver
• Laboratorio de Medicina Nuclear & Pet Inc
• Laboratorio de Patologia Dr Noy
• Laboratorio Doctor Center, Inc (Laboratorio Doctor Center 5)

• Clinical Medical Laboratory in San Juan, PR
• Providers in San Juan, 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 Apr 20, 2008; 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.