NPIMap

Organization Active NPI

Laboratorio Clinicon Colon #3

  • Clinical Medical Laboratory
  • Humacao, PR
National Provider Identifier
1871879197
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
1032 Issued in PR
Legal business name
LABORATORIO CLINICON COLON #3
Practice address
358 Ave Font Martelo
Rosado Medical Building
Humacao, PR 00791-3222
Phone
(787) 285-1680
NPI assigned
Nov 1, 2011
Last updated
Nov 1, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
LABORATORIO CLINICO DEL SURESTE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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

Authorized official

Name
Mrs. Yanire Castro, MEDICAL TECNOLOGIST
Title
Laboratory Supervisor
Phone
(787) 285-1680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 1032 PR Primary

Addresses

Primary practice location

358 Ave Font Martelo
Rosado Medical Building
Humacao, PR 00791-3222

Mailing address

PO Box 85
Yabucoa, PR 00767-0085
Phone (787) 285-1680

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070607000408 PR Part B Supplier - Independent Clinical Laboratory 7810095353 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Caguas, PR; Humacao, PR; Manuabo, PR; Yabucoa, PR

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Laboratorio Clinico del Sureste5 organizations share this tax ID, including this one
Part of
Laboratorio Clinico del Sureste

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1871879197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 85",
            "city": "YABUCOA",
            "state": "PR",
            "postal_code": "007670085",
            "telephone_number": "787-285-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 AVE FONT MARTELO",
            "address_2": "ROSADO MEDICAL BUILDING",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007913222",
            "telephone_number": "787-285-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICON COLON #3",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LABORATORIO CLINICO DEL SURESTE, INC",
        "enumeration_date": "2011-11-01",
        "last_updated": "2011-11-01",
        "status": "A",
        "authorized_official_last_name": "CASTRO",
        "authorized_official_first_name": "YANIRE",
        "authorized_official_title_or_position": "LABORATORY SUPERVISOR",
        "authorized_official_telephone_number": "787-285-1680",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MEDICAL TECNOLOGIST"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 1, 2011; 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.