Provider Demographics
NPI:1932383304
Name:CITY SLEEP LAB LLC
Entity Type:Organization
Organization Name:CITY SLEEP LAB LLC
Other - Org Name:CITY SLEEP LAB LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:DURIAS
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:206-228-1844
Mailing Address - Street 1:95 S TOBIN ST STE 205
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-5324
Mailing Address - Country:US
Mailing Address - Phone:206-228-1844
Mailing Address - Fax:
Practice Address - Street 1:95 S TOBIN ST STE 25
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5324
Practice Address - Country:US
Practice Address - Phone:206-228-1844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory