| Organization Name: | LAKESIDE CLINICAL LABORATORY LLC |
| NPI Number: | 1023472891 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY RATTI (CREDENTIALING COORDINATOR) |
| Mailing Address: | 2211 Century Center Blvd Ste 110 Irving |
| State: | TX US |
| Postal Code: | 750624960 |
| Phone Number: | 4695653300 |
| Fax Number: | |
| NPI Enumeration Date: | 04/07/2016 |
| NPI Last Update Date: | 06/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 291U00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Laboratories |
| Taxonomy Classification: | Clinical Medical Laboratory |
| Taxonomy Specialization: | |
| Taxonomy 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. |