Laboratorio Clinico San Martin

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

454 Issued in PR

Legal business name

LABORATORIO CLINICO SAN MARTIN

Practice address

75 Dr Pedro Albizu Campos
Lares, PR 00669-0787

Phone

(787) 897-2479

Fax

(787) 897-2479

NPI assigned

Sep 29, 2005

Last updated

Aug 22, 2020By 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. Fancisco A Oliver, TECNOLOGO MEDICO

Title

Supervisor

Phone

(787) 897-2479

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326035957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 787",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006690787",
            "telephone_number": "787-897-2479",
            "fax_number": "787-897-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 DR PEDRO ALBIZU CAMPOS",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006690787",
            "telephone_number": "787-897-2479",
            "fax_number": "787-897-2479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO SAN MARTIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "FANCISCO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "787-897-2479",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "TECNOLOGO MEDICO"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lares Medical Center Inc
• Lares Medical Center Inc

• Clinical Medical Laboratory in Lares, PR
• Providers in Lares, 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 Aug 22, 2020; 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.