Provider Demographics
NPI:1790482347
Name:LUCID DIAGNOSTICS LABS LLC
Entity Type:Organization
Organization Name:LUCID DIAGNOSTICS LABS LLC
Other - Org Name:SV DIAGNOSTICS LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MADHUKAR
Authorized Official - Middle Name:
Authorized Official - Last Name:NARAHARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-599-3800
Mailing Address - Street 1:1718 ALEXANDRIA DR STE 300
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3144
Mailing Address - Country:US
Mailing Address - Phone:567-304-4501
Mailing Address - Fax:
Practice Address - Street 1:1718 ALEXANDRIA DR STE 300
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3144
Practice Address - Country:US
Practice Address - Phone:281-888-8704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory