Laboratorio Clinico Covadonga,Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

00758 Issued in PR

Legal business name

LABORATORIO CLINICO COVADONGA,INC

Practice address

Aa4 Ave Don Pelayo
Haciendas del Norte
Toa Baja, PR 00949-5388

Phone

(787) 251-0138

Fax

(787) 251-0130

NPI assigned

Jan 29, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Lillian Santiago, MT

Title

Supervisor

Phone

(787) 251-0138

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188432000000",
    "number": "1124164140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AA4 AVE DON PELAYO",
            "address_2": "HACIENDAS DEL NORTE",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009495388",
            "telephone_number": "787-251-0138",
            "fax_number": "787-251-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AA4 AVE DON PELAYO",
            "address_2": "HACIENDAS DEL NORTE",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009495388",
            "telephone_number": "787-251-0138",
            "fax_number": "787-251-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO COVADONGA,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-08-30",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO",
        "authorized_official_first_name": "LILLIAN",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "787-251-0138",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "00758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Toa Baja, PR
• Clinical Medical Laboratory in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; 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.