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LAKESHORE MEDICAL CLINIC, LTD
NPI 1639374937
Durable Medical Equipment & Medical Supplies in Milwaukee, WI

Active since June 18, 2007CLIA 52D2004141 · Microscopy
180 N MILWAUKEE ST, MILWAUKEE, WI 53202(414) 227-1127 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lakeshore Medical Clinic, Ltd NPPES

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

LAKESHORE MEDICAL CLINIC, LTD (NPI 1639374937) is a healthcare organization registered as a durable medical equipment & medical supplies in Milwaukee, Wisconsin and active in the NPI registry since June 2007. The organization holds a CLIA Microscopy certificate valid through June 26, 2027 and lists Masood Wasiullah, President, as its authorized official.

NPPES Registry Identity

NPI1639374937
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameLAKESHORE MEDICAL CLINIC, LTD
Location Address180 N MILWAUKEE STMilwaukee, WI 53202-6013
Mailing Address180 N Milwaukee StMilwaukee, WI 53202-6013 · (414) 227-1127
Phone(414) 227-1127
Organization SubpartNo
Authorized OfficialMasood WasiullahPresident · (414) 744-6589
Enumeration DateJune 18, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1639374937 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition

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.

180 N MILWAUKEE ST, Milwaukee, WI 53202
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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 for Provider-Performed Microscopy Procedures (PPMP) 52D2004141

Lakeshore Medical Clinic - Third Ward · Milwaukee, WI
Active · expires Jun 26, 2027
CLIA Number52D2004141
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateJune 27, 2025
Certificate Expiration DateJune 26, 2027
Laboratory DirectorDr. Tatiana Petrikova
Laboratory Phone(414) 227-1127
Laboratory LocationLakeshore Medical Clinic - Third Ward163 N Milwaukee St, Milwaukee, WI 53202
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

IVARS GAILANS M.D.
Psychiatry & Neurology (Addiction Medicine)
180 N MILWAUKEE ST
MILWAUKEE, WI 53202
Milwaukee County (615) 778-4066
MAUREEN P. LAVIN M.D.
Preventive Medicine (Occupational Medicine)
180 N MILWAUKEE ST
MILWAUKEE, WI 53202
Milwaukee County (615) 778-4066
GREGORY BARTA P.T.
Physical Therapist
180 N MILWAUKEE ST
MILWAUKEE, WI 53202
Milwaukee County (615) 778-4066

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 Lakeshore Medical Clinic, Ltd's NPI number?

The NPI number for Lakeshore Medical Clinic, Ltd is 1639374937. It was assigned to this organization in the NPPES registry on June 18, 2007.

Where is Lakeshore Medical Clinic, Ltd located?

Lakeshore Medical Clinic, Ltd is located at 180 N Milwaukee St, Milwaukee, WI 53202. The listed phone number is (414) 227-1127.

What is Lakeshore Medical Clinic, Ltd's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Does Lakeshore Medical Clinic, Ltd hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 52D2004141) is associated with this NPI, valid through June 26, 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 Lakeshore Medical Clinic, Ltd was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.