LAKESHORE MEDICAL CLINIC LLC
NPI 1265597645
Durable Medical Equipment & Medical Supplies in Cudahy, WI
NPI Status: Active since December 26, 2006
Contact Information
5900 S LAKE DR
CUDAHY, WI
ZIP 53110
Phone: (414) 489-4190
- Organization
- Durable Medical Equipment & Medical Supp...
- CLIA Number: 52D0920902
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-13-2026
About LAKESHORE MEDICAL CLINIC LLC
This page provides the complete NPI Profile along with additional information for Lakeshore Medical Clinic Llc, a provider established in Cudahy, Wisconsin operating as a Durable Medical Equipment & Medical Supplies. The healthcare provider is registered in the NPI registry with number 1265597645 assigned on December 2006. The practitioner's primary taxonomy code is 332B00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Kara Richardson (Asst Treasurer)
- NPI
- 1265597645
- Provider Name
- LAKESHORE MEDICAL CLINIC LLC
- Entity Type
- Organization
- Location Address
- 5900 S LAKE DR CUDAHY, WI 53110
- Location Phone
- (414) 489-4190
- Mailing Address
- 5900 S LAKE DR CUDAHY, WI 53110
- Mailing Phone
- (414) 489-4190
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-26-2006
- Last Update Date
- 10-14-2025
- Code Navigator
Location Map
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
Durable Medical Equipment & Medical Supplies
- Taxonomy Code
- 332B00000X
- Type
- Suppliers
- Taxonomy Description
- A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
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
- 52D0920902
- Facility Type
- Physician Office
- Certificate Effective Date
- October 14, 2024
- Certificate Expiration Date
- October 13, 2026
- Laboratory Director
- DR. DEXTER REBANCOS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Lakeshore Medical Clinic Llc 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 1265597645, we treat the final digit (5) 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 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 65 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
CUDAHY, WI 53110
CUDAHY, WI 53110
CUDAHY, WI 53110
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1265597645, enumerated as an "organization" on December 26, 2006.
The provider is located at 5900 S LAKE DR CUDAHY, WI 53110 and the phone number is (414) 489-4190.
Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.
