Active NPI
I-Lab Corp
- Clinical Medical Laboratory
- Coamo, PR
National Provider Identifier
1528341773
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- I-LAB CORP
- Practice address
- Carr PR 14 KM. 30.0
Centro de Convenciones de Coamo
Coamo, PR 00769 - Phone
- (787) 825-7626
- NPI assigned
- Sep 23, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Susan Martinez
- Title
- Medical Technology
- Phone
- (787) 615-9102
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | PR | Primary |
Addresses
Primary practice location
Carr PR 14 KM. 30.0
Centro de Convenciones de Coamo
Coamo, PR 00769
Mailing address
100 Carr 14 Suite 1
Centro de Convenciones de Coamo
Coamo, PR 00769-2981
Phone (787) 825-7626
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120402000047 | PR | Part B Supplier - Independent Clinical Laboratory | 6406014117 | Practice locations: Coamo, PR; Juana Diaz, PR |
National Provider Directory
National Provider DirectoryLocations
100 Carr 14
Ste 1
Coamo, PR 00769
Phone (787) 446-8767
100 Carr 14
#30
Coamo, PR 00769
Phone (787) 825-7626
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316736000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1316736000000",
"number": "1528341773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 CARR 14 SUITE 1",
"address_2": "CENTRO DE CONVENCIONES DE COAMO",
"city": "COAMO",
"state": "PR",
"postal_code": "007692981",
"telephone_number": "787-825-7626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR PR 14 KM. 30.0",
"address_2": "CENTRO DE CONVENCIONES DE COAMO",
"city": "COAMO",
"state": "PR",
"postal_code": "00769",
"telephone_number": "787-825-7626"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "I-LAB CORP",
"organizational_subpart": "NO",
"enumeration_date": "2011-09-23",
"last_updated": "2011-09-23",
"status": "A",
"authorized_official_last_name": "MARTINEZ",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "MEDICAL TECHNOLOGY",
"authorized_official_telephone_number": "787-615-9102",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "PR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Coamo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; 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.