LAKESHORE SURGERY CENTER, LLP
NPI 1134586852
Clinic/Center - Ambulatory Surgical in Fort Gratiot, MI

NPI Status: Active since January 26, 2016

Contact Information

4190 24TH AVE
FORT GRATIOT, MI
ZIP 48059
Phone: (810) 989-7700

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • CLIA Number: 23D1019374
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 11-17-2027

About LAKESHORE SURGERY CENTER, LLP

This page provides the complete NPI Profile along with additional information for Lakeshore Surgery Center, Llp, a provider established in Fort Gratiot, Michigan operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1134586852 assigned on January 2016. The practitioner's primary taxonomy code is 261QA1903X with license number 746818 (MI). The provider is registered as an organization and their NPI record was last updated 10 years ago. The provider's is doing business as Lakeshore Surgery Center, Llp. The authorized official of this NPI record is Christopher Doan (Chief Compliance Counsel)

NPI
1134586852
Provider Legal Name
PRIME HEALTHCARE SERVICES-PORT HURON, LLC
Other Organization Name
LAKESHORE SURGERY CENTER, LLP
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
4190 24TH AVE FORT GRATIOT, MI 48059
Location Phone
(810) 989-7700
Mailing Address
4190 24TH AVE FORT GRATIOT, MI 48059
Mailing Phone
(810) 989-7700
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
01-26-2016
Last Update Date
01-26-2016
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities
License No.
746818
License State
MI

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

CHRISTOPHER DOAN

Authorized Official Title
CHIEF COMPLIANCE COUNSEL
Authorized Official Phone
(909) 235-4307

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
23D1019374
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
November 18, 2025
Certificate Expiration Date
November 17, 2027
Laboratory Director
FRANK A. BRETTSCHNEIDER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Lakeshore Surgery Center, Llp to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1134586852, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
3
Doubled → 6
Pos 4
4
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
8
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
8
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 5 → 10 → 1 6 → 12 → 3 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 6 + 4 + 1 + 0 + 8 + 1 + 2 + 8 + 1 + 0 + 24 = 58

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 58 is 60. The difference is the calculated check digit.

60 - 58 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1134586852.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Internal Medicine (Endocrinology, Diabetes & Metabolism)
4190 24TH AVE, SUITE:201
FORT GRATIOT, MI 48059
Internal Medicine (Endocrinology, Diabetes & Metabolism)
4190 24TH AVE, SUITE: 201
FORT GRATIOT, MI 48059
Family Medicine
4190 24TH AVE
FORT GRATIOT, MI 48059
Physician Assistant
4190 24TH AVE, SUITE 206
FORT GRATIOT, MI 48059
Nurse Anesthetist, Certified Registered
4190 24TH AVE
FORT GRATIOT, MI 48059
Podiatrist (Foot & Ankle Surgery)
4190 24TH AVE, SUITE 104
FORT GRATIOT, MI 48059
Ophthalmology
4190 24TH AVE, SUITE 204
FORT GRATIOT, MI 48059
Podiatrist (Foot & Ankle Surgery)
4190 24TH AVE, SUITE 104
FORT GRATIOT, MI 48059
Pharmacist
4190 24TH AVE
FORT GRATIOT, MI 48059
Specialist
4190 24TH AVE, SUITE 204
FORT GRATIOT, MI 48059
Family Medicine
4190 24TH AVE
FORT GRATIOT, MI 48059
Family Medicine
4190 24TH AVE
FORT GRATIOT, MI 48059
Family Medicine
4190 24TH AVE
FORT GRATIOT, MI 48059
Nurse Practitioner (Gerontology)
4190 24TH AVE
FORT GRATIOT, MI 48059
Internal Medicine
4190 24TH AVE, SUITE 206
FORT GRATIOT, MI 48059
Family Medicine
4190 24TH AVE, SUITE 206
FORT GRATIOT, MI 48059
Internal Medicine (Endocrinology, Diabetes & Metabolism)
4190 24TH AVE, SUITE 206
FORT GRATIOT, MI 48059
General Practice
4190 24TH AVE, STE 206
FORT GRATIOT, MI 48059
Internal Medicine (Endocrinology, Diabetes & Metabolism)
4190 24TH AVE, SUITE 206
FORT GRATIOT, MI 48059
Psychiatry & Neurology (Neurology)
4190 24TH AVE, SUITE 210
FORT GRATIOT, MI 48059

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1134586852, enumerated as an "organization" on January 26, 2016.

The provider is located at 4190 24TH AVE FORT GRATIOT, MI 48059 and the phone number is (810) 989-7700.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.