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
9/27/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
96.00
Location Details
Address
851 Locust Street
Rogersville, TN 37857
United States
County
Hawkins
Phone
4239217268 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Laboratory Service Provider
Map
Address