MEDICARE: OLYMPIC SLEEP LABS, INC

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	2777682	CA

General Provider Information

NPI Number	:	1861516973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLYMPIC SLEEP LABS, INC

Provider Business Mailing Address
First Line	:	2140 W OLYMPIC BLVD STE 322
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2279
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2140 W OLYMPIC BLVD STE 322
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2279
Country	:	US
Telephone Number	:	213-380-1980
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ELIZABETH LEE
Credential	:
Telephone Number	:	213-380-1980

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	08/22/2020

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