MEDICARE: SOLARIS DX, 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	:	1669249975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLARIS DX, LLC

Provider Business Mailing Address
First Line	:	110 DEWEY DR
Second Line	:
City	:	NICHOLASVILLE
State	:	KY
Zip	:	40356-7123
Country	:	US
Telephone Number	:	844-550-0308
Fax Number	:	859-305-6105

Provider Business Practice Location Address
First Line	:	8202 CLEARVISTA PKWY STE 5A
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-1431
Country	:	US
Telephone Number	:	844-550-0308
Fax Number	:	859-305-6105

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. PREETPAL SINGH SIDHU
Credential	:	PHD
Telephone Number	:	844-550-0308

Provider Enumeration Date	:	12/06/2023
Last Update Date	:	07/18/2024

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