Provider Demographics
NPI:1679920573
Name:SOLSTAS LAB PARTNERS GROUP LLC
Entity Type:Organization
Organization Name:SOLSTAS LAB PARTNERS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR-REVENUE SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:J
Authorized Official - Middle Name:PABLO
Authorized Official - Last Name:LAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-676-7000
Mailing Address - Street 1:4380 FEDERAL DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-8148
Mailing Address - Country:US
Mailing Address - Phone:336-664-6100
Mailing Address - Fax:336-852-0003
Practice Address - Street 1:1915 SOUTH 17TH STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6683
Practice Address - Country:US
Practice Address - Phone:910-362-9511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34D0981597291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory