Laboratorio Clinico Y Bacteriologico de Diego

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

304 Issued in PR

Legal business name

LABORATORIO CLINICO Y BACTERIOLOGICO DE DIEGO

Practice address

Calle de Diego # 51 Este
Mayaguez, PR 00680

Phone

(787) 833-0470

Fax

(787) 833-0470

NPI assigned

Nov 16, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Melba Enid Manzano, M.T. (ASCP)

Title

Owner-Supervisor

Phone

(787) 833-0470

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093797946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7301",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006817301",
            "telephone_number": "787-833-0470",
            "fax_number": "787-833-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE DE DIEGO # 51 ESTE",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00680",
            "telephone_number": "787-833-0470",
            "fax_number": "787-833-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO Y BACTERIOLOGICO DE DIEGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANZANO",
        "authorized_official_first_name": "MELBA",
        "authorized_official_middle_name": "ENID",
        "authorized_official_title_or_position": "OWNER-SUPERVISOR",
        "authorized_official_telephone_number": "787-833-0470",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.T. (ASCP)"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Mayaguez, PR
• Providers in Mayaguez, 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.