Provider Demographics
NPI:1770581985
Name:LABORATORIO CLINICO CLAUSELLS
Entity type:Organization
Organization Name:LABORATORIO CLINICO CLAUSELLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:GUZMAN
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-841-1401
Mailing Address - Street 1:333 CALLE VICTORIA
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-2860
Mailing Address - Country:US
Mailing Address - Phone:787-841-1401
Mailing Address - Fax:787-840-5901
Practice Address - Street 1:333 CALLE VICTORIA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-2860
Practice Address - Country:US
Practice Address - Phone:787-841-1401
Practice Address - Fax:787-840-5901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR777291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR38310Medicare ID - Type UnspecifiedCLINICAL LAB