DVW Clinical Laboratories Services

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

444 Issued in PR

Legal business name

DVW CLINICAL LABORATORIES SERVICES

Doing business as

Lab Clinico Camuy

Practice address

4 Calle Infanzon
Camuy, PR 00627-2627

Phone

(787) 898-5645

Fax

(787) 898-5645

NPI assigned

Oct 20, 2010

Last updated

Sep 24, 2012By 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. Debra Ann Velazquez, MT

Title

Medical Technologist

Phone

(787) 898-5645

Specialties & licenses 1

Addresses

Other names 1

• LAB CLINICO CAMUY Doing business as

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348444800000",
    "number": "1619287976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CALLE INFANZON",
            "city": "CAMUY",
            "state": "PR",
            "postal_code": "006272627",
            "telephone_number": "787-898-5645",
            "fax_number": "787-898-5645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CALLE INFANZON",
            "city": "CAMUY",
            "state": "PR",
            "postal_code": "006272627",
            "telephone_number": "787-898-5645",
            "fax_number": "787-898-5645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVW CLINICAL LABORATORIES SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-20",
        "last_updated": "2012-09-24",
        "status": "A",
        "authorized_official_last_name": "VELAZQUEZ",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MEDICAL  TECHNOLOGIST",
        "authorized_official_telephone_number": "787-898-5645",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAB CLINICO CAMUY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Elite Primary and Aesthetics Medicine LLC

• Clinical Medical Laboratory in Camuy, PR
• Providers in Camuy, 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 Sep 24, 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.