NPI 1124773130

Lakeshore Clinical LLC

Organisation Clinical Medical Laboratory Rockford, IL

Practice location

Address: 5411 E State St STE 4, Rockford, IL 61108-2908
Phone: (224) 310-8328
Mailing address: 7425 Nantucket Cv, Hanover Park, IL 60133-2720

Authorised official

Name: Setu Shah
Title: Ceo
Phone: (224) 310-8328

Registered specialties

Clinical Medical Laboratory Primary

Laboratories Taxonomy 291U00000X

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Registry record

NPI: 1124773130
Entity type: Organization
NPI issued: 17 Feb 2022
Record last updated: 17 Feb 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.