# EASTSIDE P.E.T. CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** UAB Medicine Sleep Center at One Nineteen
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649855545
- **Authorized official:** LISA J WELLS CPCO (SR. VICE PRESIDENT)
- **Authorized official phone:** (205) 221-8258

## Contact information

- **Practice address:** 7191 CAHABA VALLEY RD, BLDG 2 STE 203, HOOVER, AL 35242-6448
- **Practice address phone:** (205) 236-9943
- **Practice address fax:** (205) 236-9947
- **Mailing address:** 406 MEDICAL CENTER DR, JASPER, AL 35501-3400
- **Mailing address phone:** (205) 221-8200
- **Mailing address fax:** (205) 221-8270

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | — | NULL | Yes |
| 293D00000X | Physiological Laboratory | — | NULL | — |

## Other

- **Enumeration date:** 03/11/2021
- **Last updated:** 09/30/2026