Laboratorio Clinico Moderno Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

782 Issued in PR

Legal business name

LABORATORIO CLINICO MODERNO INC.

Practice address

Carretera #3 KM 86.0
Bo. Candelero Arriba
Humacao, PR 00791

Phone

(787) 850-4900

Fax

(787) 850-4900

NPI assigned

Feb 2, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Sandra M. Garcia, M.T.

Title

Laboratory Director

Phone

(787) 850-4900

Specialties & licenses 1

Addresses

Other names 1

• LABORATORIO CLINICO MODERNO Former legal business name

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194797209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890",
            "address_2": "PMB 416",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007920890",
            "telephone_number": "787-850-4900",
            "fax_number": "787-850-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA #3 KM 86.0",
            "address_2": "BO. CANDELERO ARRIBA",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-850-4900",
            "fax_number": "787-850-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO MODERNO INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "LABORATORY DIRECTOR",
        "authorized_official_telephone_number": "787-850-4900",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.T."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LABORATORIO CLINICO MODERNO",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Medical Laboratory in Humacao, PR
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• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.