Organization
LAKERIDGE LABORATORY INC
Active
Other names
lakeridge laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN E MARTIN JR. M.D. (PRESIDENT)
(512) 913-6512
Entity
Organization
Contact information
Practice address
5130 82ND ST, LUBBOCK, TX 79424-3024
(512) 913-6512
Mailing address
1712 E RIVERSIDE DR, STE 232, AUSTIN, TX 78741-1320
(512) 913-6512
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
45D0678293
TX
Other
Enumeration date
04/07/2010
Last updated
06/29/2010
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