Provider Demographics
NPI:1144564352
Name:1ST CLASS SLEEP DIAGNOSTICS, INC
Entity Type:Organization
Organization Name:1ST CLASS SLEEP DIAGNOSTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:YI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-385-9222
Mailing Address - Street 1:14631 LEE HWY
Mailing Address - Street 2:SUITE 413
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-5824
Mailing Address - Country:US
Mailing Address - Phone:703-385-9222
Mailing Address - Fax:703-373-2671
Practice Address - Street 1:6128 BRANDON AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-2640
Practice Address - Country:US
Practice Address - Phone:703-385-9222
Practice Address - Fax:703-373-2671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA107828291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory