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LAKESIDE SURGERY CENTER, LLC
NPI 1396634820
Clinic/Center - Ambulatory Surgical in Springdale, AR

Active since June 30, 2025CLIA 04D2329823 · Waiver
6845 ISAACS ORCHARD RD, SPRINGDALE, AR 72762(473) 236-2766 Get Directions Write a Review

NPPES record last updated: June 30, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lakeside Surgery Center, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKESIDE SURGERY CENTER, LLC (NPI 1396634820) is a healthcare organization registered as an ambulatory surgical in Springdale, Arkansas and active in the NPI registry since June 2025. The organization holds a CLIA Waiver certificate valid through September 4, 2027 and lists Peter Marshall Daut, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1396634820
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameLAKESIDE SURGERY CENTER, LLC
Location Address6845 ISAACS ORCHARD RDSpringdale, AR 72762
Mailing Address741 E Van Asche DrFayetteville, AR 72703-4916 · (473) 442-5227 · Fax (472) 582-4952
Phone(473) 236-2766
Organization SubpartNo
Authorized OfficialPeter Marshall DautMedical Director · (479) 442-5227
Enumeration DateJune 30, 2025
NPPES CertifiedJune 10, 2025
✔ NPI 1396634820 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
6845 ISAACS ORCHARD RD, Springdale, AR 72762
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 04D2329823

Lakeside Surgery Center · Springdale, AR
Active · expires Sep 4, 2027
CLIA Number04D2329823
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateSeptember 5, 2025
Certificate Expiration DateSeptember 4, 2027
Laboratory DirectorDr. Peter Daut
Laboratory Phone(479) 601-5891
Laboratory LocationLakeside Surgery Center6845 Isaacs Orchard Road, Springdale, AR 72762
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lakeside Surgery Center, LLC's NPI number?

The NPI number for Lakeside Surgery Center, LLC is 1396634820. It was assigned to this organization in the NPPES registry on June 30, 2025.

Where is Lakeside Surgery Center, LLC located?

Lakeside Surgery Center, LLC is located at 6845 Isaacs Orchard Rd, Springdale, AR 72762. The listed phone number is (473) 236-2766.

What is Lakeside Surgery Center, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Lakeside Surgery Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D2329823) is associated with this NPI, valid through September 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lakeside Surgery Center, LLC was last updated on June 30, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.