Clendo Lab Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

LIC.526 Issued in PR

Legal business name

CLENDO LAB INC.

Doing business as

Clendo Reference Lab

Practice address

Ave. Santa Cruz #58 Urb. Sta. Cruz
Bayamon, PR 00961-7020

Phone

(787) 620-9095

Fax

(787) 740-0902

NPI assigned

Oct 17, 2006

Last updated

Nov 1, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Idalia L Becerra

Title

Executive Director

Phone

(787) 620-9095

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Clendo Reference Lab Doing business as

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288569600000",
    "number": "1932280195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009606049",
            "telephone_number": "787-620-9095",
            "fax_number": "787-740-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE. SANTA CRUZ #58 URB. STA. CRUZ",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617020",
            "telephone_number": "787-620-9095",
            "fax_number": "787-740-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLENDO LAB INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2010-11-01",
        "status": "A",
        "authorized_official_last_name": "BECERRA",
        "authorized_official_first_name": "IDALIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "787-620-9095",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "526",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "LIC.526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE",
            "identifier": "526",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clendo Reference Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Medical Laboratory in Bayamon, PR
• Providers in Bayamon, PR by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.