Laboratorio Clinico Universitario

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

420 Issued in PR

Legal business name

LABORATORIO CLINICO UNIVERSITARIO

Practice address

Ext. Hnas Davila
Calle 2, J-12
Bayamon, PR 00959

Phone

(787) 780-0611

Fax

(787) 780-0611

NPI assigned

Apr 24, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Carmen Rosina De Jesus, BS MT

Title

Laboratory Director

Phone

(787) 780-0611

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619195492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EXT. HNAS DAVILA",
            "address_2": "CALLE 2, J-12",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959",
            "telephone_number": "787-780-0611",
            "fax_number": "787-780-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EXT. HNAS DAVILA",
            "address_2": "CALLE 2, J-12",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959",
            "telephone_number": "787-780-0611",
            "fax_number": "787-780-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO UNIVERSITARIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DE JESUS",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "ROSINA",
        "authorized_official_title_or_position": "LABORATORY DIRECTOR",
        "authorized_official_telephone_number": "787-780-0611",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BS MT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Bayamon, PR
• Providers in Bayamon, 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.