Ft Clinical Laboratories Inc
Organization Active NPI Clinical Medical Laboratory · Lares, PR
NPI 1780825166 · NPPES record last updated Mar 16, 2009
Key facts
- NPI
- 1780825166
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- License
- 186824 (PR)
- Legal business name
- FT CLINICAL LABORATORIES INC
- Practice address
- Carr 129 KM 21.8
Bo Callejones
Lares, PR 00669 - Phone
- (787) 717-8021
- NPI assigned
- Mar 16, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Eddie Fernandez-Fernandez, BSMT
- Title
- President
- Phone
- (787) 897-8365
Other NPIs on the same Medicare enrollment 1
Practitioners 1
-
Eddie Fernandez, MT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100806000201 | PR | Part B Supplier - Independent Clinical Laboratory | 5991838237 |
1 other NPI on this enrollment Practice locations: Lares, PR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 186824 | PR | Yes |
Addresses
Primary practice location
Carr 129 KM 21.8
Bo Callejones
Lares, PR 00669
Mailing address
PO Box 143233
Arecibo, PR 00614-3233
Phone (787) 897-8365
Other names
- LABORATORIO CLINICO FERNANDEZ
Other providers in Lares, PR
- Farmacia San Jose LLC
- Fe Ambulance Services Corp.
- Eddie Fernandez
- Joan Marie Fernandini
- Amarilis Lopez Figueroa
- Waleska Fuster- Cruz
- Coralis Noemi Galarza
- Griselle Galarza
- Francisco Antonio Garrastegui
- Frankie Gelabert
All providers in Lares, PR · Clinical Medical Laboratory in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.