04D2329823 CLIA NUMBER - LAKESIDE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 04D2329823
  • Facility Name: LAKESIDE SURGERY CENTER
  • Facility Address: 6845 ISAACS ORCHARD ROAD
    SPRINGDALE, AR
    ZIP 72762
  • Facility Phone: 479 601-5891
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. PETER DAUT
  • NPI Number: 1396634820
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 04D2329823
LAB Type Ambulatory Surgery Center
Facility Name LAKESIDE SURGERY CENTER
Street 6845 ISAACS ORCHARD ROAD
City SPRINGDALE
State AR
ZIP 72762
Phone 479 601-5891
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2025
Certificate Expiration Date 9/4/2027
Facility Type Ambulatory Surgery Center
Lab Director DR. PETER DAUT

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