| NPI | 1023472891 |
|---|---|
| Doing Business As | LAKESIDE CLINICAL LABORATORY |
| Entity Type | Organization |
| Authorized Contact | WILLIAM WIRTZ Owner 972-887-3444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2024-04-29 |