OrganizationActive
Lakeshore Clinical LLC
NPI 1124773130 · Clinical Medical Laboratory · Rockford, IL
Provider details
- NPI number
- 1124773130
- Entity type
- Organization
- Primary specialty
- Clinical Medical LaboratoryLaboratories
- Organization subpart
- No
- Authorized official
- Setu Shah, Ceo(224) 310-8328
Specialties & taxonomies
Laboratories
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
5411 E State St Ste 4
Rockford, IL 61108-2908
Phone: (224) 310-8328
Street-level locationGet directions
Mailing address
7425 Nantucket Cv
Hanover Park, IL 60133-2720
Registry dates
- Enumerated
- 2022-02-17
- Last updated
- 2022-02-17
- Certified
- 2022-02-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.