Odemaris Laboratory Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

1220 Issued in PR

Legal business name

ODEMARIS LABORATORY INC

Doing business as

Laboratorio Clinico Aguadillano

Practice address

Carr. 110 KM. 0.3 Bo Ceiba Baja
Aguadilla, PR 00605

Phone

(787) 891-2154

NPI assigned

Sep 24, 2010

Last updated

Apr 19, 2021By 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

Cinthia Perez

Title

Secretary

Phone

(787) 891-2154

Specialties & licenses 1

Addresses

Other names 1

• Laboratorio Clinico Aguadillano Doing business as

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": "1285286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618790400000",
    "number": "1366750374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1789",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006051789",
            "telephone_number": "787-891-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 110 KM. 0.3 BO CEIBA BAJA",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "00605",
            "telephone_number": "787-891-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODEMARIS LABORATORY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-24",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "CINTHIA",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "787-891-2154"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laboratorio Clinico Aguadillano",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Aguadilla, PR
• Providers in Aguadilla, 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 19, 2021; 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.