45D2138981 CLIA NUMBER - LANBAKE, LLC

Laboratory Demographics

  • CLIA Code: 45D2138981
  • Facility Name: LANBAKE, LLC
  • Facility Address: 8480 CENTRAL MALL DRIVE
    PORT ARTHUR, TX
    ZIP 77642
  • Facility Phone: 409 853-1288
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: GAYLA H. BAKER
  • NPI Number: 1710404637
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D2138981
LAB Type Practitioner Other
Facility Name LANBAKE, LLC
Street 8480 CENTRAL MALL DRIVE
City PORT ARTHUR
State TX
ZIP 77642
Phone 409 853-1288
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2023
Certificate Expiration Date 10/26/2025
Facility Type Practitioner Other
Lab Director GAYLA H. BAKER

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