Organization Active NPI

I-Lab Corp

  • Clinical Medical Laboratory
  • Coamo, PR
National Provider Identifier
1528341773
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
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

Updated by the provider on Sep 23, 2011

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
O20120402000047 PR Part B Supplier - Independent Clinical Laboratory 6406014117 Practice locations: Coamo, PR; Juana Diaz, PR

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.