Provider Demographics
NPI:1104972637
Name:OHIO VALLEY SLEEP DIAGNOSTICS, LLC
Entity type:Organization
Organization Name:OHIO VALLEY SLEEP DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:A
Authorized Official - Last Name:REA
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:304-372-2848
Mailing Address - Street 1:137 CLAY LICK RD
Mailing Address - Street 2:STE B
Mailing Address - City:RIPLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25271-9241
Mailing Address - Country:US
Mailing Address - Phone:304-372-2848
Mailing Address - Fax:
Practice Address - Street 1:137 CLAY LICK RD
Practice Address - Street 2:STE B
Practice Address - City:RIPLEY
Practice Address - State:WV
Practice Address - Zip Code:25271-9241
Practice Address - Country:US
Practice Address - Phone:304-372-2848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV808346291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory