Laboratorio Clinico Shalom Corporation

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

1080 Issued in PR

Legal business name

LABORATORIO CLINICO SHALOM CORPORATION

Practice address

Calle Marginal del Parque Bo Terranova
Carretera #2
Quebradillas, PR 00678

Phone

(787) 895-4999

Fax

(787) 895-6945

NPI assigned

Jan 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Eduardo Rodriguez VazquezNPI 1457395683

Title

Presidente

Phone

(787) 919-7277

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 1

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

• Eduardo Rodriguez Vazquez

  • General Practice Physician
  • San Sebastian, PR
  • NPI 1457395683
  NPD (past) Authorized official

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551657600000",
    "number": "1487709721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 903",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "00678",
            "telephone_number": "787-919-7277",
            "fax_number": "787-280-9497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE MARGINAL DEL PARQUE BO TERRANOVA",
            "address_2": "CARRETERA #2",
            "city": "QUEBRADILLAS",
            "state": "PR",
            "postal_code": "00678",
            "telephone_number": "787-895-4999",
            "fax_number": "787-895-6945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO SHALOM CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2019-03-04",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ VAZQUEZ",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_title_or_position": "PRESIDENTE",
        "authorized_official_telephone_number": "787-919-7277",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krizias Drug
• Laboratorio Clinico Las Mercedes Inc
• Laboratorio Clinico Monroig
• Laboratorio Clinico San Antonio
• Laboratorio Clinico Shaddai PSC
• Laboratorio Clinico Sofia LLC
• Laboratorio San Rafael
• Laboratorio San Rafael Quebradillas, Inc.
• Laboratorio San Rafael Quebradillas, Inc.
• Lcsa LLC

• Clinical Medical Laboratory in Quebradillas, PR
• Providers in Quebradillas, 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 Mar 4, 2019; 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.