MEDICARE: LUCID DIAGNOSTICS LABS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1790482347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUCID DIAGNOSTICS LABS LLC

Provider Business Mailing Address
First Line	:	1718 ALEXANDRIA DR STE 300
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3144
Country	:	US
Telephone Number	:	567-304-4501
Fax Number	:

Provider Business Practice Location Address
First Line	:	1718 ALEXANDRIA DR STE 300
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3144
Country	:	US
Telephone Number	:	281-888-8704
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MADHUKAR NARAHARI
Credential	:
Telephone Number	:	614-599-3800

Provider Enumeration Date	:	02/14/2023
Last Update Date	:	04/17/2024

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