LABORATORIO CLINICO COUNTRY CLUB
NPI 1154308674
Clinical Medical Laboratory in San Juan, PR

Active since December 27, 2005CLIA 40D0699932 · Certificate of Compliance
#758 AVE CAMPO RICO, COUNTRY CLUB, SAN JUAN, PR 00924(787) 750-0510(787) 257-1110 Get Directions Write a Review

NPPES record last updated: October 21, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Laboratorio Clinico Country Club NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LABORATORIO CLINICO COUNTRY CLUB (NPI 1154308674) is a healthcare organization registered as a clinical medical laboratory in San Juan, Puerto Rico and active in the NPI registry since December 2005. The organization holds a CLIA Certificate of Compliance certificate valid through June 11, 2028 and lists Edwin Cardona, Owner, as its authorized official.

NPPES Registry Identity

NPI1154308674
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameLABORATORIO CLINICO COUNTRY CLUB
Location Address#758 AVE CAMPO RICO, COUNTRY CLUBSan Juan, PR 00924
Mailing Address1353 Carr. #19, Pmb #364Guaynabo, PR 00966-2701 · (787) 750-0510 · Fax (787) 257-1110
Fax(787) 257-1110
Organization SubpartNo
Authorized OfficialEdwin CardonaOwner · (787) 748-4102
Enumeration DateDecember 27, 2005
Last NPPES UpdateOctober 21, 2008
NPI 1154308674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
License Licensed in PR · 147
Definition

(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

Other Identifiers 1

Medicare PIN0030893PR

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 40D0699932

Laboratorio Clinico Country Club · San Juan, PR
Active · expires Jun 11, 2028
CLIA Number40D0699932
Laboratory TypeIndependent
Certificate Effective DateJune 12, 2026
Certificate Expiration DateJune 11, 2028
Laboratory DirectorHedda Ortiz
Laboratory Phone(787) 750-0510
Laboratory LocationLaboratorio Clinico Country ClubAve Campo Rico Num 758 Country Club, San Juan, PR 00924
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Laboratorio Clinico Country Club's NPI number?

The NPI number for Laboratorio Clinico Country Club is 1154308674. It was assigned to this organization in the NPPES registry on December 27, 2005.

Where is Laboratorio Clinico Country Club located?

Laboratorio Clinico Country Club is located at #758 Ave Campo Rico Country Club, San Juan, PR 00924. The listed phone number is (787) 750-0510.

What is Laboratorio Clinico Country Club's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Laboratorio Clinico Country Club hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 40D0699932) is associated with this NPI, valid through June 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Laboratorio Clinico Country Club was last updated on October 21, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.