40D2211780 CLIA NUMBER - CMRC HEADLANDS LLC

Laboratory Demographics

  • CLIA Code: 40D2211780
  • Facility Name: CMRC HEADLANDS LLC
  • Facility Address: 121 DOMENECH AVE
    SAN JUAN, PR
    ZIP 00918
  • Facility Phone: 787 291-9058
  • Facility Type: Other - DEDICATED CLINICAL RESEA
  • Facility Type: Waiver
  • Lab Director: DR. CARMEN C. DESEDA
  • NPI Number: 1154510535
  • Taxonomy: 1223P0221X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 40D2211780
LAB Type Other - DEDICATED CLINICAL RESEA
Facility Name CMRC HEADLANDS LLC
Street 121 DOMENECH AVE
City SAN JUAN
State PR
ZIP 00918
Phone 787 291-9058
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2025
Certificate Expiration Date 1/31/2027
Facility Type Other - DEDICATED CLINICAL RESEA
Lab Director DR. CARMEN C. DESEDA

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