1639285091 NPI number — MB CLINICAL LABORATORIES CORP.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639285091 NPI number — MB CLINICAL LABORATORIES CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MB CLINICAL LABORATORIES CORP.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639285091
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/04/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 476
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JUNCOS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00777-0476
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-734-8126
Provider Business Mailing Address Fax Number:
787-734-1927

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 174 KM 12.1
Provider Second Line Business Practice Location Address:
BARRIO MULAS
Provider Business Practice Location Address City Name:
AGUAS BUENAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-732-0210
Provider Business Practice Location Address Fax Number:
787-732-0210
Provider Enumeration Date:
08/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FLORES
Authorized Official First Name:
JOSE
Authorized Official Middle Name:
CARLOS
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-475-8731

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  888 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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