LAKE DIAGNOSTICS INC. NPI 1134130172

NPI Information

  • NPI: 1134130172
  • Provider Name: LAKE DIAGNOSTICS, INC.
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 3550 PONTIAC LAKE RD
    WATERFORD, MI
    ZIP 48328
  • Phone: (248) 674-8199

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NPI Details

LAKE DIAGNOSTICS, INC. is a specialist in Waterford, MI. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. LAKE DIAGNOSTICS, INC. NPI is 1134130172. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3550 PONTIAC LAKE RD
WATERFORD, MI
ZIP 48328-337
Phone: (248) 674-8199
Fax: (248) 674-8205

The provider's authorized official is Joel Leib .
The authorized official title is President/owner and has the following contact phone number (248) 674-8199.

The enumeration date for this NPI number is 8/11/2006 and was last updated on 12/8/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13175190-10MEDICAIDMICHIGAN
21013935071OTHERMICHIGANNPI OSTERBERGER
32905598-11MEDICARE ID-TYPE UNSPECIFIEDMICHIGANMEDICAID SILVERMAN
41588661391OTHERMICHIGANNPI ELKISS
51346212800OTHERMICHIGANNPI BORIN
62905373-11MEDICARE ID-TYPE UNSPECIFIEDMICHIGANMEDICAID ELKISS
7CA2712OTHERMICHIGANRAILROAD MEDICARE
84876216-11MEDICAIDMICHIGAN
91891751509OTHERMICHIGANNPI KOVAN
101356349062OTHERMICHIGANNPI SILVERMAN
114168987-10MEDICAIDMICHIGAN
124661544-11MEDICAIDMICHIGAN
134876314-11MEDICAIDMICHIGAN
143225247-10MEDICAIDMICHIGAN
151437181146OTHERMICHIGANNPI MELLEN
161376540286OTHERMICHIGANNPI KACHADURIAN
171205824505OTHERMICHIGANNPI RUBIN
18700F313270OTHERMICHIGANBCBS GROUP PROVIDER
190M28100MEDICARE ID-TYPE UNSPECIFIEDMICHIGANMEDICARE GROUP PROVIDER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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