Healthcare Provider Details

I. General information

NPI: 1235172065
Provider Name (Legal Business Name): DESERT MOON SLEEP LAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 E FLAMINGO RD STE H
LAS VEGAS NV
89121-5270
US

IV. Provider business mailing address

2860 E FLAMINGO RD STE H
LAS VEGAS NV
89121-5270
US

V. Phone/Fax

Practice location:
  • Phone: 702-696-9002
  • Fax: 702-696-9482
Mailing address:
  • Phone: 702-696-9002
  • Fax: 702-696-9482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. PEDRO MORALES DURIAS II
Title or Position: OWNER/LAB MANAGER
Credential: RPSGT
Phone: 702-696-9002