40D2296270 CLIA NUMBER - DR LUIS M MONTALVO BONILLA

Laboratory Demographics

  • CLIA Code: 40D2296270
  • Facility Name: DR LUIS M MONTALVO BONILLA
  • Facility Address: 404 AVENIDA JOSE DE DIEGO
    ARECIBO, PR
    ZIP 00612
  • Facility Phone: 787 878-2758
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LUIS M. MONTALVO BONILLA
  • NPI Number: 1316146087
  • Taxonomy: 207RP1001X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 40D2296270
LAB Type Physician Office
Facility Name DR LUIS M MONTALVO BONILLA
Street 404 AVENIDA JOSE DE DIEGO
City ARECIBO
State PR
ZIP 00612
Phone 787 878-2758
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/26/2023
Certificate Expiration Date 12/25/2025
Facility Type Physician Office
Lab Director LUIS M. MONTALVO BONILLA

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