Contract Details
Ancillary Care Services
Facility name
Solstas Lab Partners Group
Provider ID
P000004316
NPI
1346233277
Tax ID
562017400
Effective Date
4/1/2012
Last Updated
10/17/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
96.00
Location Details
Address
660 Singleton Ridge Road Suite B
Conway, SC 29528
United States
County
Horry
Phone
8423474416 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address