Provider Demographics
NPI:1346313749
Name:SOLSTAS LAB PARTNERS LLC
Entity Type:Organization
Organization Name:SOLSTAS LAB PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP REVENUE SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:J PABLO
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-676-7000
Mailing Address - Street 1:213 S JEFFERSON ST
Mailing Address - Street 2:SUITE 1201
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24011-1705
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:BELLEVIEW AT JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014
Practice Address - Country:US
Practice Address - Phone:540-855-9560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA190001418Medicare ID - Type UnspecifiedVA-MEDICARE-LBS
VA190000963Medicare ID - Type UnspecifiedVA-MEDICARE-CO1