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10D1107131 CLIA NUMBER - LAKESIDE MEDICAL, LLC

Laboratory Demographics

CLIA Number: 10D1107131

Facility Name: LAKESIDE MEDICAL, LLC

Facility Address:
600 N HIATUS RD STE 203
PEMBROKE PINES, FL
ZIP 33026
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Facility Phone Number: 954 392-7157

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1356820286

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 10D1107131
LAB Type Physician Office
Facility Name LAKESIDE MEDICAL, LLC
Street 600 N HIATUS RD STE 203
City PEMBROKE PINES
State FL
ZIP 33026
Phone 954 392-7157
CertificateType 4
CertificateEffectiveDate 10/28/2023
CertificateExpirationDate 10/27/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024