Specialty Labs of Puerto Rico

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SPECIALTY LABS OF PUERTO RICO

Doing business as

Laboratorio Clinico Mayaguez

Practice address

142 Calle Mayaguez
San Juan, PR 00917-5163

Phone

(787) 274-0551

Fax

(866) 537-0423

NPI assigned

Feb 20, 2023

Last updated

Apr 2, 2024By 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

Mr. Daniel Leger

Title

President & Ceo

Phone

(787) 274-0551

Specialties & licenses 1

Addresses

Other names 1

• Laboratorio Clinico Mayaguez Doing business as

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Tax ID family

Specialty Labs2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Specialty Labs

  • Clinical Medical Laboratory
  • Boynton Beach, FL
  • NPI 1902767775
  NPD tax ID

Locations

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1285332353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741621",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334741621",
            "telephone_number": "787-274-0551",
            "fax_number": "787-332-1736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 CALLE MAYAGUEZ",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175163",
            "telephone_number": "787-274-0551",
            "fax_number": "866-537-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY LABS OF PUERTO RICO",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-20",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "LEGER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "787-274-0551",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laboratorio Clinico Mayaguez",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Laboratorio Clinico Mayaguez",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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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 Apr 2, 2024; 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.