Lakeridge Laboratory Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

45D0678293 Issued in TX

Legal business name

LAKERIDGE LABORATORY INC

Practice address

5130 82ND St
Lubbock, TX 79424-3024

Phone

(512) 913-6512

NPI assigned

Apr 7, 2010

Organization subpart

No

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

Authorized official

Name

Juan E Martin Jr., M.D.

Title

President

Phone

(512) 913-6512

Specialties & licenses 1

Addresses

Other names 1

• lakeridge laboratory Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1972829513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 E RIVERSIDE DR",
            "address_2": "STE 232",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787411320",
            "telephone_number": "512-913-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 82ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794243024",
            "telephone_number": "512-913-6512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKERIDGE LABORATORY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-07",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-913-6512",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": "45D0678293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "lakeridge laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Lafreniere
• Christina Lain, B.S., SLPA
• Margaret Smith Lair, LCSW
• Tanya Michele Lair, NP
• Lakeridge Family Dentistry & Orthodontics
• Lakeside Senior Care LLC
• Lalavie LLC
• Judy Lalmuanpuii, MD
• Wailong Don Lam, PNP
• David Winton Lamberts, M.D.

• Clinical Medical Laboratory in Lubbock, TX
• Providers in Lubbock, 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 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.