Laboratorio Clinico Tiago Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

1253 Issued in PR

Legal business name

LABORATORIO CLINICO TIAGO INC.

Practice address

Urb. San Feliz
Calle 1 Num a-2
Corozal, PR 00783

Phone

(787) 859-1823

Fax

(787) 859-1823

NPI assigned

Apr 10, 2012

Last updated

Jun 19, 2012By 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

Mrs. Lizbeth Diaz, MT

Title

President

Phone

(787) 859-1823

Specialties & licenses 1

Addresses

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": "1334016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340064000000",
    "number": "1073879425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 5634",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "009538956",
            "telephone_number": "787-859-1823",
            "fax_number": "787-859-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. SAN FELIZ",
            "address_2": "CALLE 1 NUM A-2",
            "city": "COROZAL",
            "state": "PR",
            "postal_code": "00783",
            "telephone_number": "787-859-1823",
            "fax_number": "787-859-1823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO TIAGO INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-10",
        "last_updated": "2012-06-19",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "LIZBETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-859-1823",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Kiley, D.M.D.
• Laboratorio Clinico Cibuco Inc
• Laboratorio Clinico Collazo LLC
• Laboratorio Clinico Corozal Inc
• Laboratorio Clinico Corozal, Inc. (Laboratorio Clinico Corozal II)
• Laboratorio Rodriguez,Inc.
• Lauren Lau Angarita, MD
• Joswelyn Laureano, PHARMACY TECHNICIAN
• LGS Ambulance LLC
• LJP, LLC

• Clinical Medical Laboratory in Corozal, PR
• Providers in Corozal, 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 Jun 19, 2012; 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.