40D2188669 CLIA NUMBER - APS CLINICS OF PR- SAN JUAN NINOS

Laboratory Demographics

CLIA Number: 40D2188669

Facility Name: APS CLINICS OF PR- SAN JUAN NINOS

Facility Address:
VIG PLAZA- 1215 AVE PONCE DE LEON, SUITE 102
SAN JUAN, PR
ZIP 00907
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Facility Phone Number: 787 641-0774

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1740640770

Taxonomy: 261QM0801X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	40D2188669
LAB Type	Physician Office
Facility Name	APS CLINICS OF PR- SAN JUAN NINOS
Street	VIG PLAZA- 1215 AVE PONCE DE LEON, SUITE 102
City	SAN JUAN
State	PR
ZIP	00907
Phone	787 641-0774
CertificateType	4
CertificateEffectiveDate	7/21/2022
CertificateExpirationDate	7/20/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024