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LAS LOMAS LABORATORY INC.
Complete NPI Record 1043283971
Clinical Medical Laboratory in San Juan, PR

NPI Status: Active since February 10, 2006

Contact Information

AVE. JESUS T PINERO ESQ. AVE. SAN PATRICIO LOCAL 32
LAS LOMAS PROFESIONAL CENTER
SAN JUAN, PR
ZIP 00921
Phone: (787) 792-1824
Fax: (787) 783-6350

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider Other Organization Name
  6. Provider Other Organization Name Type Code
  7. Provider First Line Business Mailing Address
  8. Provider Business Mailing Address City Name
  9. Provider Business Mailing Address State Name
  10. Provider Business Mailing Address Postal Code
  11. Provider Business Mailing Address Country Code If outside U S
  12. Provider Business Mailing Address Telephone Number
  13. Provider Business Mailing Address Fax Number
  14. Provider First Line Business Practice Location Address
  15. Provider Second Line Business Practice Location Address
  16. Provider Business Practice Location Address City Name
  17. Provider Business Practice Location Address State Name
  18. Provider Business Practice Location Address Postal Code
  19. Provider Business Practice Location Address Country Code If outside U S
  20. Provider Business Practice Location Address Telephone Number
  21. Provider Business Practice Location Address Fax Number
  22. Provider Enumeration Date
  23. Last Update Date
  24. Authorized Official Last Name
  25. Authorized Official First Name
  26. Authorized Official Title or Position
  27. Authorized Official Telephone Number
  28. Healthcare Provider Taxonomy Code 1
  29. Provider License Number 1
  30. Provider License Number State Code 1
  31. Healthcare Provider Primary Taxonomy Switch 1
  32. Other Provider Identifier 1
  33. Other Provider Identifier Type Code 1
  34. Other Provider Identifier State 1
  35. Other Provider Identifier Issuer 1
  36. Other Provider Identifier 2
  37. Other Provider Identifier Type Code 2
  38. Other Provider Identifier State 2
  39. Other Provider Identifier Issuer 2
  40. Other Provider Identifier 3
  41. Other Provider Identifier Type Code 3
  42. Other Provider Identifier State 3
  43. Other Provider Identifier Issuer 3
  44. Other Provider Identifier 4
  45. Other Provider Identifier Type Code 4
  46. Other Provider Identifier State 4
  47. Other Provider Identifier Issuer 4
  48. Other Provider Identifier 5
  49. Other Provider Identifier Type Code 5
  50. Other Provider Identifier State 5
  51. Other Provider Identifier Issuer 5
  52. Other Provider Identifier 6
  53. Other Provider Identifier Type Code 6
  54. Other Provider Identifier State 6
  55. Other Provider Identifier Issuer 6
  56. Other Provider Identifier 7
  57. Other Provider Identifier Type Code 7
  58. Other Provider Identifier State 7
  59. Other Provider Identifier Issuer 7
  60. Other Provider Identifier 8
  61. Other Provider Identifier Type Code 8
  62. Other Provider Identifier State 8
  63. Other Provider Identifier Issuer 8
  64. Other Provider Identifier 9
  65. Other Provider Identifier Type Code 9
  66. Other Provider Identifier State 9
  67. Other Provider Identifier Issuer 9
  68. Other Provider Identifier 10
  69. Other Provider Identifier Type Code 10
  70. Other Provider Identifier State 10
  71. Other Provider Identifier Issuer 10
  72. Other Provider Identifier 11
  73. Other Provider Identifier Type Code 11
  74. Other Provider Identifier State 11
  75. Other Provider Identifier Issuer 11
  76. Other Provider Identifier 12
  77. Other Provider Identifier Type Code 12
  78. Other Provider Identifier State 12
  79. Other Provider Identifier Issuer 12
  80. Other Provider Identifier 13
  81. Other Provider Identifier Type Code 13
  82. Other Provider Identifier State 13
  83. Other Provider Identifier Issuer 13
  84. Is Organization Subpart
  85. Parent Organization LBN
  86. Parent Organization TIN
  87. Authorized Official Name Prefix Text

Complete NPI Dataset

This page represents the complete record for NPI 1043283971. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1043283971
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization Name: LAB. CLINICO LAS LOMAS
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code: 4
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: PO BOX 367027
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: SAN JUAN
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: PR
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 009367027
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 7877921824
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 7877836350
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: AVE. JESUS T PINERO ESQ. AVE. SAN PATRICIO LOCAL 32
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location Address: LAS LOMAS PROFESIONAL CENTER
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: SAN JUAN
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: PR
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 009211489
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 7877921824
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 7877836350
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 2/10/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 11/20/2015
The date that a record was last updated or changed.
Authorized Official Last Name: LOPEZ-LOPEZ
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: WILSON
The first name of the authorized official.
Authorized Official Title or Position: PRESIDENTE
The title or position of the authorized official.
Authorized Official Telephone Number: 7877921824
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 291U00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 374
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: PR
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: =========
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: PR
Other Provider Identifier Issuer 1: PREFERRED MEDICAL CHOICE
Other Provider Identifier 2: 400309
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2: PR
Other Provider Identifier Issuer 2: UTI PREFERRED HEALTH PLAN
Other Provider Identifier 3: LB374
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 3: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 3: PR
Other Provider Identifier Issuer 3: UIA
Other Provider Identifier 4: LA0304
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 4: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 4: PR
Other Provider Identifier Issuer 4: PANAMERICAN LIFE INS
Other Provider Identifier 5: =========
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 5: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 5: PR
Other Provider Identifier Issuer 5: MAPFRELIFE INSURANCE
Other Provider Identifier 6: =========
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 6: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 6: PR
Other Provider Identifier Issuer 6: CIGNA LIFE INSURANCE
Other Provider Identifier 7: 051822
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 7: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 7: PR
Other Provider Identifier Issuer 7: LA CRUZ AZUL PR
Other Provider Identifier 8: 31498
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 8: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 8: PR
Other Provider Identifier Issuer 8: TRIPLE S
Other Provider Identifier 9: 6578
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 9: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 9: PR
Other Provider Identifier Issuer 9: INTERNATIONAL MEDICAL CAR
Other Provider Identifier 10: =========
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 10: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 10: PR
Other Provider Identifier Issuer 10: COVIMED
Other Provider Identifier 11: =========
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 11: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 11: PR
Other Provider Identifier Issuer 11: MEDICAL CARD SYSTEMS
Other Provider Identifier 12: 800313
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 12: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 12: PR
Other Provider Identifier Issuer 12: MEDICARE Y MUCHO MAS
Other Provider Identifier 13: 9210002
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 13: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 13: PR
Other Provider Identifier Issuer 13: HUMANA INSURANCE
Is Organization Subpart: Y
Parent Organization LBN: LAS LOMAS LABORATORY INC
Parent Organization TIN: UNAVAIL
Authorized Official Name Prefix Text: MR.