Laboratorio Clinico Luquillo, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

1337 Issued in PR

Legal business name

LABORATORIO CLINICO LUQUILLO, LLC

Practice address

Calle 13 Parcela # 52
Barrio Fortuna LL
Luquillo, PR 00773

Phone

(787) 534-4329

Fax

(787) 534-6586

NPI assigned

Mar 21, 2016

Last updated

Oct 3, 2016By 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

Mrs. Wanda I Aviles, M.T.

Title

General Supervisor

Phone

(787) 648-9360

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1458518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475452800000",
    "number": "1316309255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CARR 194 STE 100",
            "address_2": "FDO CINEMA BLDG",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007382927",
            "telephone_number": "787-534-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE 13 PARCELA # 52",
            "address_2": "BARRIO FORTUNA LL",
            "city": "LUQUILLO",
            "state": "PR",
            "postal_code": "00773",
            "telephone_number": "787-534-4329",
            "fax_number": "787-534-6586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO LUQUILLO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-21",
        "last_updated": "2016-10-03",
        "status": "A",
        "authorized_official_last_name": "AVILES",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "GENERAL SUPERVISOR",
        "authorized_official_telephone_number": "787-648-9360",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.T."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA ID NUMBER",
            "identifier": "40 D 2105017",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Integrate Community Health System (Metro Pavia Clinic Luquillo - Clinica)
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• Kyntan Enterprises (Farmacia Caridad #5)
• Life Link Ambulance Corp
• Luis R Llaneza, DDS
• Nizza Kyona Llanos, RN
• Marie Sandra Lopez Balaez, OT
• Edgar Lopez Vazquez

• Clinical Medical Laboratory in Luquillo, PR
• Providers in Luquillo, 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 Oct 3, 2016; 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.