| Lake Diagnostics, Inc. | |
|
3550 Pontiac Lake Rd Waterford MI 48328-2337 | |
| (248) 674-8199 | |
| (248) 674-8205 |
| Full Name | Lake Diagnostics, Inc. |
|---|---|
| Speciality | Clinic/center |
| Location | 3550 Pontiac Lake Rd, Waterford, Michigan |
| Authorized Official Name and Position | Joel Leib (PRESIDENT) |
| Authorized Official Contact | 2486260766 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Diagnostics, Inc. 31800 Northwestern Hwy Suite 370 Farmington Hills MI 48334-1655 Ph: (248) 626-0766 | Lake Diagnostics, Inc. 3550 Pontiac Lake Rd Waterford MI 48328-2337 Ph: (248) 674-8199 |
| NPI Number | 1700821188 |
|---|---|
| Provider Enumeration Date | 06/18/2006 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700821188 | NPI | - | NPPES |
| COFEG | Other | MI | BILLING LOCATOR CODE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Michigan) | Primary |
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