Laboratorio San Rafael Quebradillas, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

0399 Issued in PR

Legal business name

LABORATORIO SAN RAFAEL QUEBRADILLAS, INC.

Practice address

109 Calle San Carlos
Quebradillas, PR 00678-1737

Phone

(787) 895-2333

NPI assigned

Dec 14, 2012

Organization subpart

No

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

Authorized official

Name

Yolanda Arias, M.T.

Title

Administrator

Phone

(787) 895-2333

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Laboratorio San Rafael Quebradillas, Inc.

  • Clinical Medical Laboratory
  • Quebradillas, PR
  • NPI 1609397900

  O20150331000828

  Same enrollment

Tax ID family

Laboratorio San Rafael Quebradillas Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Laboratorio San Rafael Quebradillas, Inc.

  • Clinical Medical Laboratory
  • Quebradillas, PR
  • NPI 1609397900
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Laboratorio San Rafael Quebradillas, Inc.

  • Clinical Medical Laboratory
  • Quebradillas, PR
  • NPI 1609397900
  NPPES parent name

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

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1093051393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CALLE SAN CARLOS",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "006781737",
            "telephone_number": "787-895-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CALLE SAN CARLOS",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "006781737",
            "telephone_number": "787-895-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO SAN RAFAEL QUEBRADILLAS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-14",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "ARIAS",
        "authorized_official_first_name": "YOLANDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-895-2333",
        "authorized_official_credential": "M.T."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "0399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laboratorio Clinico San Antonio
• Laboratorio Clinico Shaddai PSC
• Laboratorio Clinico Shalom Corporation
• Laboratorio Clinico Sofia LLC
• Laboratorio San Rafael
• Laboratorio San Rafael Quebradillas, Inc.
• Lcsa LLC
• Le Vista Corp.
• Zaimary Liciaga Lopez, PSYD
• Life Alert Ambulance Inc

• Clinical Medical Laboratory in Quebradillas, PR
• Providers in Quebradillas, 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 6, 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.