Laboratorio Clinico Magdalena Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

579 Issued in PR

Legal business name

LABORATORIO CLINICO MAGDALENA INC.

Practice address

1452 Ashford Ave
Suite 309
San Juan, PR 00907-1563

Phone

(787) 725-5235

Fax

(787) 725-5229

NPI assigned

Jun 23, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Lizette J. Torres, M.T.

Title

Owner/General Supervisor

Phone

(787) 725-5235

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": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468800000000",
    "number": "1194751081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1452 ASHFORD AVE",
            "address_2": "SUITE 309",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009071563",
            "telephone_number": "787-725-5235",
            "fax_number": "787-725-5229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1452 ASHFORD AVE",
            "address_2": "SUITE 309",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009071563",
            "telephone_number": "787-725-5235",
            "fax_number": "787-725-5229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO MAGDALENA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2016-07-18",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "LIZETTE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER/GENERAL SUPERVISOR",
        "authorized_official_telephone_number": "787-725-5235",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.T."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Jul 18, 2016; 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.