Laboratorio Clinico de Diego Corp

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

6708

Legal business name

LABORATORIO CLINICO DE DIEGO CORP

Practice address

27TH Ave Severiano Cuevas
Aguadilla, PR 00603

Phone

(787) 891-6350

NPI assigned

May 5, 2006

Organization subpart

No

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

Authorized official

Name

Fidel Clemente De Frias, MD

Title

Director

Phone

(787) 891-6350

Specialties & licenses 1

Addresses

Other names 1

• Laboratorio Clinico Jose de Diego Former legal business name

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 4

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

• Fidel C De Frias Jimenez, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Aguadilla, PR
  • NPI 1518915024
  NPD
• Ilia Marie Morales Melecio, MD

  • Specialist
  • San Juan, PR
  • NPI 1023211869
  NPD (past)
• Federico Salcedo-Irizarry, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • San Juan, PR
  • NPI 1033470794
  NPD (past)
• Julio Alberto Valentin, MD

  • Anatomic Pathology Physician
  • Aguadilla, PR
  • NPI 1295052728
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332979200000",
    "number": "1609824119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5183",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "00605",
            "telephone_number": "787-891-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27TH AVE SEVERIANO CUEVAS",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "00603",
            "telephone_number": "787-891-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO DE DIEGO CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2012-03-29",
        "status": "A",
        "authorized_official_last_name": "DE FRIAS",
        "authorized_official_first_name": "FIDEL",
        "authorized_official_middle_name": "CLEMENTE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "787-891-6350",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": "6708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laboratorio Clinico Jose de Diego",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Medical Laboratory in Aguadilla, PR
• Providers in Aguadilla, 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 29, 2012; 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.