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General NPI Number Information
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NPI Number | 1649455460
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Entity Type | Organization
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Legal Business Name | SLEEP DISORDER DIAGNOSTIC CENTER, LLC
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Dates
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Enumeration Date | 12/31/2007
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 2323 S TROY ST 4-100
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City | AURORA
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State | CO
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Zip | 80014-1946
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Country | US
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Telephone | 303-696-2426
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Fax | 303-696-2436
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Provider Business Mailing Address
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Address Line | 2323 S TROY ST 4-100
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City | AURORA
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State | CO
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Zip | 80014-1946
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Country | US
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Telephone | 303-696-2426
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Fax | 303-696-2436
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. VALENTINA SHERMAN
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Credential |
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Telephone | 303-696-2426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 156756
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License Number State | CO
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