Provider Demographics
NPI:1750501490
Name:C-O-P-D SLEEP LAB, LLC
Entity Type:Organization
Organization Name:C-O-P-D SLEEP LAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:JO
Authorized Official - Last Name:JANACEK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:972-563-7533
Mailing Address - Street 1:303 E COLLEGE ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160-2717
Mailing Address - Country:US
Mailing Address - Phone:972-563-7533
Mailing Address - Fax:
Practice Address - Street 1:303 E COLLEGE ST
Practice Address - Street 2:SUITE F
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-2717
Practice Address - Country:US
Practice Address - Phone:903-455-2885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory