Laboratorio Clinico Domus Corp

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LABORATORIO CLINICO DOMUS CORP

Practice address

Carr 486 KM 1.9
Barrio Zanja
Camuy, PR 00627-0479

Phone

(787) 820-2170

NPI assigned

Mar 1, 2023

Organization subpart

No

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

Authorized official

Name

Ivette Del C Cruz, MT

Title

President

Phone

(787) 898-0600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• LABORATORIO CLINICO DOMUS CORP Former legal business name

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": "1677628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1083313860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 479",
            "city": "CAMUY",
            "state": "PR",
            "postal_code": "006270479",
            "telephone_number": "787-898-0600",
            "fax_number": "787-609-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 486 KM 1.9",
            "address_2": "BARRIO ZANJA",
            "city": "CAMUY",
            "state": "PR",
            "postal_code": "006270479",
            "telephone_number": "787-820-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO DOMUS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-02-27",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "IVETTE",
        "authorized_official_middle_name": "DEL C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-898-0600",
        "authorized_official_credential": "MT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8662982772",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LABORATORIO CLINICO DOMUS CORP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• JH Ambulance Services Corp
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• Laboratorio Clinico Camuy
• Laboratorio Clinico Delgado Amador, PSC
• Laboratorio Clinico Familiar Zarza
• Laboratorio Clinico Irizarry Guasch Inc
• Laboratorio Clinico Lopez LLC
• Laboratorio Clinico Sinai, LLC
• Laboratorio Clinico Vega CSP

• Clinical Medical Laboratory in Camuy, PR
• Providers in Camuy, 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 1, 2023; 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.