Organization Active NPI

Laboratorio Clinico El Yunque LLC

  • Clinical Medical Laboratory
  • Rio Grande, PR
National Provider Identifier
1881414795
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
LABORATORIO CLINICO EL YUNQUE LLC
Practice address
Marginal Carr 3 KM 27.0, Local #4, Bo Jimenez
Rio Grande, PR 00745
Phone
(787) 377-3295
NPI assigned
Oct 15, 2024
Last updated
Mar 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Authorized official

Name
Jelissa Vargas Roldan
Title
Medical Laboratory Scientist (MLS)
Phone
(787) 377-3295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

Marginal Carr 3 KM 27.0, Local #4, Bo Jimenez
Rio Grande, PR 00745

Mailing address

496 Urb Los Arboles Pajuil a 29
Rio Grande, PR 00745
Phone (787) 377-3295

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250623001986 PR Part B Supplier - Independent Clinical Laboratory 4880106228 Practice locations: Rio Grande, 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": "1728950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742428800000",
    "number": "1881414795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 URB LOS ARBOLES PAJUIL A 29",
            "city": "RIO GRANDE",
            "state": "PR",
            "postal_code": "00745",
            "telephone_number": "787-377-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MARGINAL CARR 3 KM 27.0, LOCAL #4, BO JIMENEZ",
            "city": "RIO GRANDE",
            "state": "PR",
            "postal_code": "00745",
            "telephone_number": "787-377-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO EL YUNQUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-15",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A",
        "authorized_official_last_name": "VARGAS ROLDAN",
        "authorized_official_first_name": "JELISSA",
        "authorized_official_title_or_position": "MEDICAL LABORATORY SCIENTIST (MLS)",
        "authorized_official_telephone_number": "787-377-3295"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Grande, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; 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.