NPIMap

Organization Active NPI

Laboratorio Clnico Y Bacteriologico Rodriguez Inc

  • Clinical Medical Laboratory
  • Humacao, PR
National Provider Identifier
1639615917
Registry record updated Jul 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
1165 Issued in PR
Legal business name
LABORATORIO CLNICO Y BACTERIOLOGICO RODRIGUEZ INC
Practice address
Carr PR 924 KM 2
HM 8
Humacao, PR 00791
Phone
(787) 852-7722
Fax
(787) 733-7788
NPI assigned
Jan 11, 2017
Organization subpart
Yes
Parent organization
LABORATORIO CLINICO Y BACTERIOLOGICO RODRIGUEZ INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 19, 2017

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

Authorized official

Name
Mrs. Reina M Hernandez, MT
Title
Lab Director
Phone
(787) 733-1404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 1165 PR Primary

Addresses

Primary practice location

Carr PR 924 KM 2
HM 8
Humacao, PR 00791

Mailing address

100 Calle Jose C Barbosa
Las Piedras, PR 00771
Phone (787) 733-1404

Other identifiers 2

IdentifierTypeStateIssuer
1165OtherPRSTATE LIC
40D1086589OtherPRCLIA

Other names 1

  • LABORATORIO CLINICO PITAHAYA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170722000104 PR Part B Supplier - Independent Clinical Laboratory 0547225757 Practice locations: Humacao, PR

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Laboratorio Clnico Y Bacteriologico Rodriguez Inc2 organizations share this tax ID, including this one
Part of
Laboratorio Clnico Y Bacteriologico Rodriguez Inc

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1484092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500422400000",
    "number": "1639615917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CALLE JOSE C BARBOSA",
            "city": "LAS PIEDRAS",
            "state": "PR",
            "postal_code": "00771",
            "telephone_number": "787-733-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR PR 924 KM 2",
            "address_2": "HM 8",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-852-7722",
            "fax_number": "787-733-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLNICO Y BACTERIOLOGICO RODRIGUEZ INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LABORATORIO CLINICO Y BACTERIOLOGICO RODRIGUEZ INC",
        "enumeration_date": "2017-01-11",
        "last_updated": "2017-07-19",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "REINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "LAB DIRECTOR",
        "authorized_official_telephone_number": "787-733-1404",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC",
            "identifier": "1165",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "40D1086589",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LABORATORIO CLINICO PITAHAYA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Humacao, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2017; 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.