40D0721188 CLIA NUMBER - PRIMARY MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 40D0721188
  • Facility Name: PRIMARY MEDICAL GROUP
  • Facility Address: EDIFICIO SAN ANTONIO -24 MENDEZ VIGO
    PONCE, PR
    ZIP 00733
  • Facility Phone: 787 259-3362
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. IRAIDA DEL RIO
  • NPI Number: 1003372319
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 40D0721188
LAB Type Physician Office
Facility Name PRIMARY MEDICAL GROUP
Street EDIFICIO SAN ANTONIO -24 MENDEZ VIGO
City PONCE
State PR
ZIP 00733
Phone 787 259-3362
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Physician Office
Lab Director DR. IRAIDA DEL RIO

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This page was last updated on: 9/29/2025