Laboratorio Clinico Principal Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

332 Issued in PR

Legal business name

LABORATORIO CLINICO PRINCIPAL INC

Practice address

BB26 Ave Santa Juanita
Bayamon, PR 00956-4695

Phone

(787) 780-5120

Fax

(787) 780-8285

NPI assigned

Oct 17, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Roseanne Marie Amado

Title

Administrator

Phone

(783) 960-0372

Specialties & licenses 2

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": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194714709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1528",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009601528",
            "telephone_number": "787-780-5120",
            "fax_number": "787-780-8285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BB26 AVE SANTA JUANITA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009564695",
            "telephone_number": "787-780-5120",
            "fax_number": "787-780-8285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO PRINCIPAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AMADO",
        "authorized_official_first_name": "ROSEANNE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "783-960-0372",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "332",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laboratorio Clinico Martin Inc
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• Laboratorio Clinico North Main
• Laboratorio Clinico Pura Vida, LLP
• Laboratorio Clinico Renacer LLC
• Laboratorio Clinico Rex, Inc.
• Laboratorio Clinico San Fernando
• Laboratorio Clinico Sant Rosa

• Clinical Medical Laboratory in Bayamon, PR
• Providers in Bayamon, 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.
• 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.