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NPI Code Detail

MEDICARE: DESERT MOON SLEEP LAB LLC

MEDICARE: DESERT MOON SLEEP LAB 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
1261QS1200XSleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number : 1235172065
Entity Type Code : Organization
Provider Name (Legal Business Name) : DESERT MOON SLEEP LAB LLC
Provider Business Mailing Address
First Line : 2860 E FLAMINGO RD STE H
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-5270
Country : US
Telephone Number : 702-696-9002
Fax Number : 702-696-9482
Provider Business Practice Location Address
First Line : 2860 E FLAMINGO RD STE H
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-5270
Country : US
Telephone Number : 702-696-9002
Fax Number : 702-696-9482
Authorized Official
Title or Position : OWNER/LAB MANAGER
Name : MR. PEDRO MORALES DURIAS II
Credential : RPSGT
Telephone Number : 702-696-9002
Provider Enumeration Date : 06/13/2006
Last Update Date : 09/02/2025

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Directions to “DESERT MOON SLEEP LAB LLC ” Practice Location

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