Active NPI
Laboratorio Clinico Loiza Valley Inc.
- Clinical Medical Laboratory
- Canovanas, PR
National Provider Identifier
1598769861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 694
- Legal business name
- LABORATORIO CLINICO LOIZA VALLEY INC.
- Practice address
- Loiza Valley Mall
Bauhinia Z-977
Canovanas, PR 00729 - Phone
- (787) 876-0430
- Fax
- (787) 256-1836
- NPI assigned
- Jun 2, 2005
- 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
- Ms. Sandra Milagros Salicrup, MT
- Title
- Director
- Phone
- (787) 876-0430
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 694 | PR | Primary |
Addresses
Primary practice location
Loiza Valley Mall
Bauhinia Z-977
Canovanas, PR 00729
Mailing address
PO Box 937
Canovanas, PR 00729-0937
Phone (787) 876-0430
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 400111 | Other | PR | PREFERRED HEALTH |
| 00694 | Other | PR | GLOBAL HEALTH PLAN |
| 051290 | Other | PR | LA CRUZ AZUL DE PR |
| 20401 | Other | PR | AMERICAN HEALTH INC. |
| 30568 | Other | PR | BLUE CROSS BLUE SHIELD |
| 1424-3 | Other | PR | ASOCIACION DE MAESTROS |
| 30568 | Other | PR | TRIPLE SSS |
| 6004296 | Other | PR | ACAA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080325000092 | PR | Part B Supplier - Independent Clinical Laboratory | 8022194505 | Practice locations: Canovanas, PR |
National Provider Directory
National Provider DirectoryLocations
977 Calle Bauhinia
Canovanas, PR 00729
Phone (787) 256-1541
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117670400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1598769861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 937",
"city": "CANOVANAS",
"state": "PR",
"postal_code": "007290937",
"telephone_number": "787-876-0430",
"fax_number": "787-256-1836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "LOIZA VALLEY MALL",
"address_2": "BAUHINIA Z-977",
"city": "CANOVANAS",
"state": "PR",
"postal_code": "00729",
"telephone_number": "787-876-0430",
"fax_number": "787-256-1836"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LABORATORIO CLINICO LOIZA VALLEY INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-06-02",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SALICRUP",
"authorized_official_first_name": "SANDRA",
"authorized_official_middle_name": "MILAGROS",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "787-876-0430",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "MT"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "PR",
"license": "694",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED HEALTH",
"identifier": "400111",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GLOBAL HEALTH PLAN",
"identifier": "00694",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LA CRUZ AZUL DE PR",
"identifier": "051290",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN HEALTH INC.",
"identifier": "20401",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "30568",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASOCIACION DE MAESTROS",
"identifier": "1424-3",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIPLE SSS",
"identifier": "30568",
"state": "PR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACAA",
"identifier": "6004296",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canovanas, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.