LAKEWOOD CCL, LLC
NPI 1922575802
Clinic/Center - Multi-Specialty in Wildwood, FL
NPI Status: Active since October 29, 2018
Contact Information
5571 E SR 44 STE 501
WILDWOOD, FL
ZIP 34785
Phone: (352) 643-9070
Fax: (352) 571-6787
- Organization
- Clinic/Center
- Multi-Specialty
- CLIA Number: 10D2167678
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-16-2028
About LAKEWOOD CCL, LLC
This page provides the complete NPI Profile along with additional information for Lakewood Ccl, Llc, a provider established in Wildwood, Florida operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1922575802 assigned on October 2018. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 8 years ago. The authorized official of this NPI record is Mr. Jose A Rivera (Administrator)
- NPI
- 1922575802
- Provider Name
- LAKEWOOD CCL, LLC
- Entity Type
- Organization
- Location Address
- 5571 E SR 44 STE 501 WILDWOOD, FL 34785
- Location Phone
- (352) 643-9070
- Location Fax
- (352) 571-6787
- Mailing Address
- 5571 E SR 44 STE 501 WILDWOOD, FL 34785
- Mailing Phone
- (352) 643-9070
- Mailing Fax
- (352) 571-6787
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-29-2018
- Last Update Date
- 10-29-2018
- 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
Clinic/Center Multi-Specialty
- Taxonomy Code
- 261QM1300X
- Type
- Ambulatory Health Care Facilities
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
- 10D2167678
- Facility Type
- Physician Office
- Certificate Effective Date
- January 17, 2026
- Certificate Expiration Date
- January 16, 2028
- Laboratory Director
- VINOD R. MIRYALA
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Lakewood Ccl, Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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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 1922575802, 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.
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 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1922575802, enumerated as an "organization" on October 29, 2018.
The provider is located at 5571 E SR 44 STE 501 WILDWOOD, FL 34785 and the phone number is (352) 643-9070.
Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.
