Laboratorio Clinico Millennium CSP

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

2158 Issued in PR

Legal business name

LABORATORIO CLINICO MILLENNIUM CSP

Practice address

449 Carr 3
Urb. Buso Calle Marginal #5
Humacao, PR 00791-4635

Phone

(787) 285-0588

Fax

(787) 285-0568

NPI assigned

Feb 4, 2006

Last updated

May 11, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Maria Ivette Diaz, M.T

Title

Lab Director

Phone

(787) 285-0588

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": "1139011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1174595011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9077",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007929077",
            "telephone_number": "787-285-0588",
            "fax_number": "787-285-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 CARR 3",
            "address_2": "URB. BUSO CALLE MARGINAL #5",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007914635",
            "telephone_number": "787-285-0588",
            "fax_number": "787-285-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO MILLENNIUM CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-04",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "IVETTE",
        "authorized_official_title_or_position": "LAB DIRECTOR",
        "authorized_official_telephone_number": "787-285-0588",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.T"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "2158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Laboratorio Clinico Manued Inc.
• Laboratorio Clinico Moderno Inc.
• Laboratorio Clinico Profesional Melendez
• Laboratorio Clinico Quinones Inc
• Laboratorio Clinico Roxell Inc
• Laboratorio Clinico Trixymar, Plaza del Mar

• Clinical Medical Laboratory in Humacao, PR
• Providers in Humacao, 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 May 11, 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.