Organization Active NPI

Clinical Laboratory Services of Manati, Inc

Doing business as Laboratorio Clinico Manati

  • Clinical Medical Laboratory
  • Manati, PR
National Provider Identifier
1619115755
Registry record updated Jan 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
350 Issued in PR
Legal business name
CLINICAL LABORATORY SERVICES OF MANATI, INC
Doing business as
Laboratorio Clinico Manati
Practice address
B6 Calle Marginal
Urb San Salvador
Manati, PR 00674-4906
Phone
(787) 884-5886
Fax
(787) 884-5886
NPI assigned
Jan 28, 2009
Last updated
Jan 28, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2009

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

Authorized official

Name
Mr. Elliot Morales, APA
Title
President
Phone
(787) 884-5886

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 350 PR Primary

Addresses

Primary practice location

B6 Calle Marginal
Urb San Salvador
Manati, PR 00674-4906

Mailing address

B6 Calle Marginal
Urbanizacion San Salvador
Manati, PR 00674-4906
Phone (787) 884-5886

Other names 1

  • LABORATORIO CLINICO MANATI Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090827000714 PR Part B Supplier - Independent Clinical Laboratory 1153476023 1 other NPI on this enrollment
Practice locations: Manati, PR; Arecibo, PR

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Clinical Laboratory Services of Manati Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1233100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233100800000",
    "number": "1619115755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "B6 CALLE MARGINAL",
            "address_2": "URBANIZACION SAN SALVADOR",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006744906",
            "telephone_number": "787-884-5886",
            "fax_number": "787-884-5886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "B6 CALLE MARGINAL",
            "address_2": "URB SAN SALVADOR",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006744906",
            "telephone_number": "787-884-5886",
            "fax_number": "787-884-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL LABORATORY SERVICES OF MANATI, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-28",
        "last_updated": "2009-01-28",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "ELLIOT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-884-5886",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APA"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LABORATORIO CLINICO MANATI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manati, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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.