40D2310708 CLIA NUMBER - INTEGRATED RENAL CENTER SAN JUAN

Laboratory Demographics

  • CLIA Code: 40D2310708
  • Facility Name: INTEGRATED RENAL CENTER SAN JUAN
  • Facility Address: 725 AVE PONCE DE LEON PDA 37/ 5
    SAN JUAN, PR
    ZIP 00918
  • Facility Phone: 787 710-2532
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: DR. GLENDA MIRANDA
  • NPI Number: 1700645447
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 40D2310708
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name INTEGRATED RENAL CENTER SAN JUAN
Street 725 AVE PONCE DE LEON PDA 37/ 5
City SAN JUAN
State PR
ZIP 00918
Phone 787 710-2532
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2024
Certificate Expiration Date 9/8/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director DR. GLENDA MIRANDA

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