Provider Demographics
NPI:1144469396
Name:LABORATORIO CLINICO CONSTANCIA INC
Entity type:Organization
Organization Name:LABORATORIO CLINICO CONSTANCIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAGAN
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:787-849-3845
Mailing Address - Street 1:PO BOX 5103
Mailing Address - Street 2:PMB 154
Mailing Address - City:CABO ROJO
Mailing Address - State:PR
Mailing Address - Zip Code:00623-5103
Mailing Address - Country:US
Mailing Address - Phone:787-849-3845
Mailing Address - Fax:787-849-3845
Practice Address - Street 1:PLAZA CONSTANCIA #207
Practice Address - Street 2:
Practice Address - City:HORMIGUEROS
Practice Address - State:PR
Practice Address - Zip Code:00660
Practice Address - Country:US
Practice Address - Phone:787-849-3845
Practice Address - Fax:787-849-3845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory