1598769861 NPI number — LABORATORIO CLINICO LOIZA VALLEY INC.

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 1598769861 NPI number — LABORATORIO CLINICO LOIZA VALLEY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LABORATORIO CLINICO LOIZA VALLEY INC.
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:
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:
1598769861
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 937
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CANOVANAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00729-0937
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-876-0430
Provider Business Mailing Address Fax Number:
787-256-1836

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
LOIZA VALLEY MALL
Provider Second Line Business Practice Location Address:
BAUHINIA Z-977
Provider Business Practice Location Address City Name:
CANOVANAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-876-0430
Provider Business Practice Location Address Fax Number:
787-256-1836
Provider Enumeration Date:
06/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SALICRUP
Authorized Official First Name:
SANDRA
Authorized Official Middle Name:
MILAGROS
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
787-876-0430

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  694 , 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)

  • Identifier: 400111 . This is a "PREFERRED HEALTH" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 00694 . This is a "GLOBAL HEALTH PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 051290 . This is a "LA CRUZ AZUL DE PR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 20401 . This is a "AMERICAN HEALTH INC." identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 30568 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 1424-3 . This is a "ASOCIACION DE MAESTROS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 30568 . This is a "TRIPLE SSS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6004296 . This is a "ACAA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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