Laboratoro Clinico Expreso Trujillo Alto Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

750 Issued in PR

Legal business name

LABORATORO CLINICO EXPRESO TRUJILLO ALTO INC

Practice address

G1B Calle Frontera
Urb. Villa Andalucia
San Juan, PR 00926

Phone

(787) 748-2580

Fax

(787) 292-7966

NPI assigned

Dec 27, 2005

Organization subpart

No

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

Authorized official

Name

Edwin Cardona, MT

Title

President

Phone

(787) 748-4102

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1174500698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 CARRETERA NO 19",
            "address_2": "PMB # 364",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00966",
            "telephone_number": "787-748-2580",
            "fax_number": "787-292-7966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G1B CALLE FRONTERA",
            "address_2": "URB. VILLA ANDALUCIA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-748-2580",
            "fax_number": "787-292-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORO CLINICO EXPRESO TRUJILLO ALTO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-27",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "CARDONA",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-748-4102",
        "authorized_official_credential": "MT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Laboratorios San Juan PSC
• Gabriel Laborde Corretjer, M.D.
• Janine Laborde Sanfiorenzo, M.D.
• Vanesa Laboy Colon
• Joed Marie Laboy Descartes, M.D.
• Gladys Maria Laboy Garcia, PHD

• Clinical Medical Laboratory in San Juan, PR
• Providers in San Juan, 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 Sep 9, 2008; 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.