NPIMap

Organization Active NPI

Laboratorio Clinico Santa Cruz Corp.

  • Clinical Medical Laboratory
  • Trujillo Alto, PR
National Provider Identifier
1740328400
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
1076 Issued in PR
Legal business name
LABORATORIO CLINICO SANTA CRUZ CORP.
Practice address
181 St. KM 9.2
Quebrada Grande
Trujillo Alto, PR 00977
Phone
(787) 755-8751
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

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

Authorized official

Name
Mr. Luis Fernando Herrera, LIC. 5496
Title
Supervisor General
Phone
(787) 755-8751

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 1076 PR Primary

Addresses

Primary practice location

181 St. KM 9.2
Quebrada Grande
Trujillo Alto, PR 00977

Mailing address

PO Box 2510
PMB 208
Trujillo Alto, PR 00977-2510
Phone (787) 755-8751

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040528001187 PR Part B Supplier - Independent Clinical Laboratory 9638060353 Practice locations: Trujillo Alto, PR

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207180800000",
    "number": "1740328400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2510",
            "address_2": "PMB 208",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009772510",
            "telephone_number": "787-755-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 ST. KM 9.2",
            "address_2": "QUEBRADA GRANDE",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "00977",
            "telephone_number": "787-755-8751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO SANTA CRUZ CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2008-04-03",
        "status": "A",
        "authorized_official_last_name": "HERRERA",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "FERNANDO",
        "authorized_official_title_or_position": "SUPERVISOR GENERAL",
        "authorized_official_telephone_number": "787-755-8751",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LIC. 5496"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trujillo Alto, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; 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.