Laboratorio Clinico Costa Isabela Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LABORATORIO CLINICO COSTA ISABELA INC.

Practice address

8494 Ave Jobos # Pmb120
Isabela, PR 00662-2143

Phone

(787) 872-4603

Fax

(787) 872-4603

NPI assigned

Apr 14, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Glenda L Lopez, LCDA.

Title

President

Phone

(787) 872-4603

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220313600000",
    "number": "1154595965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8494 AVE JOBOS # PMB120",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "006622143",
            "telephone_number": "787-872-4603",
            "fax_number": "787-872-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8494 AVE JOBOS # PMB120",
            "city": "ISABELA",
            "state": "PR",
            "postal_code": "006622143",
            "telephone_number": "787-872-4603",
            "fax_number": "787-872-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO COSTA ISABELA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2008-09-02",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-872-4603",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCDA."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farzad A. Khazraee, O.D.
• Kyrios Internal Medicine Services
• Lab Clinico Villanueva
• Laboratorio Cardona Lamela, Inc.
• Laboratorio Clinicio Prosalud Isabela PSC
• Laboratorio Clinico Irizarry Guasch Inc
• Laboratorio Clinico Jobos Inc.
• Laboratorio Clinico la Familia
• Laboratorio Clinico la Familia LLC
• Laboratorio Clinico Portal del Sol

• All providers in Isabela, PR
• Clinical Medical Laboratory in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2008; 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.