Provider Demographics
NPI:1497902928
Name:NEVADA SLEEP DIAGNOSTICS, INC.
Entity Type:Organization
Organization Name:NEVADA SLEEP DIAGNOSTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:LABANOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:702-990-7660
Mailing Address - Street 1:8935 S PECOS RD STE 22D
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7155
Mailing Address - Country:US
Mailing Address - Phone:702-990-7660
Mailing Address - Fax:702-990-7665
Practice Address - Street 1:661 S BLAGG RD
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-2112
Practice Address - Country:US
Practice Address - Phone:702-990-7660
Practice Address - Fax:702-990-7665
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEVADA SLEEP DIAGNOSTICS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-27
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9072261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100511259Medicaid
NV100511259Medicaid