40D2038107 CLIA NUMBER - ST JUDE NURSING HOME INC

Laboratory Demographics

  • CLIA Code: 40D2038107
  • Facility Name: ST JUDE NURSING HOME INC
  • Facility Address: 1214 JOSE ABAD ST CLUB MANOR
    SAN JUAN, PR
    ZIP 00924
  • Facility Phone: 787 776-3013
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MR. HECTOR JACA
  • NPI Number: 1275902348
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 40D2038107
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ST JUDE NURSING HOME INC
Street 1214 JOSE ABAD ST CLUB MANOR
City SAN JUAN
State PR
ZIP 00924
Phone 787 776-3013
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/13/2024
Certificate Expiration Date 3/12/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MR. HECTOR JACA

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