Active NPI
Laboratorio Clinico Corozal, Inc.
Doing business as Laboratorio Clinico Corozal II
- Clinical Medical Laboratory
- Corozal, PR
National Provider Identifier
1578719050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 1160
- Legal business name
- LABORATORIO CLINICO COROZAL, INC.
- Doing business as
- Laboratorio Clinico Corozal II
- Practice address
- Road 159 KM 15.3
Bo. Pueblo
Corozal, PR 00783 - Phone
- (787) 859-2465
- Fax
- (787) 859-8072
- NPI assigned
- Aug 15, 2008
- Last updated
- Aug 15, 2008
- 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
- Miss Milagros De Jesus
- Title
- Director
- Phone
- (787) 859-2465
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 1160 | PR | Primary |
Addresses
Primary practice location
Road 159 KM 15.3
Bo. Pueblo
Corozal, PR 00783
Mailing address
PO Box 900
Corozal, PR 00783-0900
Phone (787) 859-2465
Other names 1
- Laboratorio Clinico Corozal II
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090120000120 | PR | Part B Supplier - Independent Clinical Laboratory | 3072676980 |
1 other NPI on this enrollment Practice locations: Corozal, PR |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Clinical Medical Laboratory
- Corozal, PR
- NPI 1528176591
O20090120000120
National Provider Directory
National Provider Directory- Tax ID family
- Lab Clinico Corozal
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Medical Laboratory
- Corozal, PR
- NPI 1528176591
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218758400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1218758400000",
"number": "1578719050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 900",
"city": "COROZAL",
"state": "PR",
"postal_code": "007830900",
"telephone_number": "787-859-2465",
"fax_number": "787-859-8072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ROAD 159 KM 15.3",
"address_2": "BO. PUEBLO",
"city": "COROZAL",
"state": "PR",
"postal_code": "00783",
"telephone_number": "787-859-2465",
"fax_number": "787-859-8072"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LABORATORIO CLINICO COROZAL, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2008-08-15",
"last_updated": "2008-08-15",
"status": "A",
"authorized_official_last_name": "DE JESUS",
"authorized_official_first_name": "MILAGROS",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "787-859-2465",
"authorized_official_name_prefix": "Miss"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "PR",
"license": "1160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Laboratorio Clinico Corozal II",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Corozal, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; 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.