Organization Active NPI

Laboratorio Clinico Barrazas Inc

  • Clinical Medical Laboratory
  • Carolina, PR
National Provider Identifier
1265916605
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
LABORATORIO CLINICO BARRAZAS INC
Practice address
A2 Avenida Roberto Sanchez Vilella
Castellana Garden
Carolina, PR 00983
Phone
(787) 985-1710
NPI assigned
Sep 21, 2018
Organization subpart
Yes
Parent organization
LABORATORIO CLINICO BARRAZAS 2As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Authorized official

Name
Yadith Del Valle
Title
Mt
Phone
(787) 776-1300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

A2 Avenida Roberto Sanchez Vilella
Castellana Garden
Carolina, PR 00983

Mailing address

HC 645 Box 6344
Trujillo Alto, PR 00976
Phone (787) 349-7841

Other identifiers 1

IdentifierTypeStateIssuer
1376860635MedicaidPR

Other names 1

  • laboratorio Clinico Barrazas 2 Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100823000989 PR Part B Supplier - Independent Clinical Laboratory 5799809083 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Carolina, PR

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Lab Clinico Barra Inc2 organizations share this tax ID, including this one
Part of
Lab Clinico Barra Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537488000000",
    "number": "1265916605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 645 BOX 6344",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "00976",
            "telephone_number": "787-349-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "A2 AVENIDA ROBERTO SANCHEZ VILELLA",
            "address_2": "CASTELLANA GARDEN",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00983",
            "telephone_number": "787-985-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO BARRAZAS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LABORATORIO CLINICO BARRAZAS 2",
        "enumeration_date": "2018-09-21",
        "last_updated": "2018-09-21",
        "status": "A",
        "authorized_official_last_name": "DEL VALLE",
        "authorized_official_first_name": "YADITH",
        "authorized_official_title_or_position": "MT",
        "authorized_official_telephone_number": "787-776-1300"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376860635",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "laboratorio Clinico Barrazas 2",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "laboratorio Clinico Barrazas 2",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Carolina, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; 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.