Prolab Diagnostics LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PROLAB DIAGNOSTICS LLC

Practice address

3705 Lakeview Pkwy Ste 209
Rowlett, TX 75088-4179

Phone

(218) 594-3177

NPI assigned

Dec 8, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elisha Castillo

Title

Owner

Phone

(218) 594-3177

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1765152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780444800000",
    "number": "1306709258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 LAKEVIEW PKWY STE 209",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750884179",
            "telephone_number": "218-594-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 LAKEVIEW PKWY STE 209",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750884179",
            "telephone_number": "218-594-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLAB DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-08",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "ELISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-594-3177"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Rowlett, TX
• Providers in Rowlett, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.