NPIMap

Organization Active NPI

Laboratorio Clinico Y de Ref de Fajardo Inc

Doing business as Laboratorio Clinico CDT de Rio Grande

  • Clinical Medical Laboratory
  • Rio Grande, PR
National Provider Identifier
1639908643
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
LABORATORIO CLINICO Y DE REF DE FAJARDO INC
Doing business as
Laboratorio Clinico CDT de Rio Grande
Practice address
Numero 200 Calle Manuel Pimentel Y Castro
Rio Grande, PR 00745
Phone
(787) 936-7676
NPI assigned
Jul 29, 2024
Last updated
Apr 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Authorized official

Name
Ana J. Oliveras-Laguna
Title
Administrator
Phone
(787) 801-0081

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

Numero 200 Calle Manuel Pimentel Y Castro
Rio Grande, PR 00745

Mailing address

PO Box 70006
Fajardo, PR 00738-7006
Phone (787) 801-0081

Other names 1

  • LABORATORIO CLINICO CDT DE RIO GRANDE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241112001502 PR Part B Supplier - Independent Clinical Laboratory 0042246712 Practice locations: Rio Grande, 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
Centro de Diagnostico Y Tratamiento Ceiba Medical Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

200 Calle Pimentel Final
Rio Grande, PR 00745
Phone (787) 936-7676

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Caribbean Medical CenterFajardo, PR, CCN 400131 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1997
Centro Medico del NoresteFajardo, PR, CCN 400141 Hospital 5% Or Greater Direct Ownership Interest (33.28%) Oct 25, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777507200000",
    "number": "1639908643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70006",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007387006",
            "telephone_number": "787-801-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NUMERO 200 CALLE MANUEL PIMENTEL Y CASTRO",
            "city": "RIO GRANDE",
            "state": "PR",
            "postal_code": "00745",
            "telephone_number": "787-936-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO Y DE REF DE FAJARDO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-29",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A",
        "authorized_official_last_name": "OLIVERAS-LAGUNA",
        "authorized_official_first_name": "ANA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-801-0081"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LABORATORIO CLINICO CDT DE RIO GRANDE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rio Grande, PR

Sources for this page

Verify at the official NPI Registry.