Provider Demographics
NPI:1073831921
Name:DIAMOND DIAGNOSTICS
Entity Type:Organization
Organization Name:DIAMOND DIAGNOSTICS
Other - Org Name:SLEEP ANALYSTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:W
Authorized Official - Last Name:DIAMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-334-9095
Mailing Address - Street 1:PO BOX 577
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63702-0577
Mailing Address - Country:US
Mailing Address - Phone:573-334-9095
Mailing Address - Fax:573-334-0960
Practice Address - Street 1:3262 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-2609
Practice Address - Country:US
Practice Address - Phone:573-334-9095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-16
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC1047927173F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173F00000XOther Service ProvidersSleep Specialist, PhDGroup - Single Specialty