Organization Active NPI

Laboratorio Clinico J Rodriguez, LLC

  • Clinical Medical Laboratory
  • Sabana Grande, PR
National Provider Identifier
1407407018
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
LABORATORIO CLINICO J RODRIGUEZ, LLC
Practice address
23 Calle Francisco M Quinonez
Sabana Grande, PR 00637-1942
Phone
(787) 873-2721
Fax
(787) 873-2557
NPI assigned
Sep 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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

Authorized official

Name
Dr. Jerimer J Rodriguez-VelezNPI 1710118815
Title
Owner
Phone
(787) 506-0994

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

23 Calle Francisco M Quinonez
Sabana Grande, PR 00637-1942

Mailing address

23 Calle Francisco M Quinonez
Sabana Grande, PR 00637-1942
Phone (787) 873-2721

Other identifiers 1

IdentifierTypeStateIssuer
291U00000XOtherTAXONOMY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200325001411 PR Part B Supplier - Independent Clinical Laboratory 0941634281 Practice locations: Sabana Grande, PR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
40D0670351Laboratorio Clinico J Rodriguez, LLC23 Calle Francisco Marrero Quinones, Sabana Grande, PR 00637ComplianceJul 9, 2028

National Provider Directory

National Provider Directory

Locations

23 Calle Francisco M Quinonez
Sabana Grande, PR 00637
Phone (787) 646-7602

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569369600000",
    "number": "1407407018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 CALLE FRANCISCO M QUINONEZ",
            "city": "SABANA GRANDE",
            "state": "PR",
            "postal_code": "006371942",
            "telephone_number": "787-873-2721",
            "fax_number": "787-873-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CALLE FRANCISCO M QUINONEZ",
            "city": "SABANA GRANDE",
            "state": "PR",
            "postal_code": "006371942",
            "telephone_number": "787-873-2721",
            "fax_number": "787-873-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO J RODRIGUEZ, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-25",
        "last_updated": "2019-09-25",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ-VELEZ",
        "authorized_official_first_name": "JERIMER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-506-0994",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "291U00000X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sabana Grande, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.