Lab Susua

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

05323 Issued in PR

Legal business name

LAB SUSUA

Practice address

Bo Susua Alta Carr 368 KM 10.7
Yauco, PR 00698-9688

Phone

(787) 856-5211

Fax

(787) 856-5211

NPI assigned

Feb 8, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Omayra Rodriguez, MT

Title

Medical Technology

Phone

(787) 836-5211

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

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

{
    "created_epoch": "1360281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397433600000",
    "number": "1316286420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 4 BOX 11824",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006989688",
            "telephone_number": "787-856-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BO SUSUA ALTA CARR 368 KM 10.7",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006989688",
            "telephone_number": "787-856-5211",
            "fax_number": "787-856-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAB SUSUA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-08",
        "last_updated": "2014-04-14",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "OMAYRA",
        "authorized_official_title_or_position": "MEDICAL TECHNOLOGY",
        "authorized_official_telephone_number": "787-836-5211",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "05323",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "05576",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kpharma, LLC
• Laboratorio Clinico Almacigo
• Laboratorio Clinico C & C , CSP
• Laboratorio Clinico Catala & Vicente Inc.
• Laboratorio Clinico Catala Vicente
• Laboratorio Clinico Irizarry Guasch Inc

• Clinical Medical Laboratory in Yauco, PR
• Providers in Yauco, 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 14, 2014; 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.