Healthcare Provider Details

I. General information

NPI: 1306872965
Provider Name (Legal Business Name): SOMNO DIAGNOSTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 01/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16061 DOCTORS BOULEVARD
HAMMOND LA
70403
US

IV. Provider business mailing address

P.O. BOX 1775
MANDEVILLE LA
70470-1775
US

V. Phone/Fax

Practice location:
  • Phone: 985-727-7900
  • Fax: 985-727-7333
Mailing address:
  • Phone: 985-727-7900
  • Fax: 985-727-7333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. MADELEINE MULA LEWIS
Title or Position: MANAGER
Credential:
Phone: 985-727-7900