# DVL VASCULAR LAB INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114919065
- **Authorized official:** MRS. SHARON KAYE ROBERTS RVT (PRESIDENT)
- **Authorized official phone:** (937) 220-9934

## Contact information

- **Practice address:** 627 S EDWIN C MOSES BLVD, SUITE 3H, DAYTON, OH 45417-3461
- **Practice address phone:** (937) 220-9934
- **Practice address fax:** (937) 220-9936
- **Mailing address:** PO BOX 276, ENGLEWOOD, OH 45322-0276
- **Mailing address phone:** (937) 220-9934
- **Mailing address fax:** (937) 220-9936

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085U0001X | Diagnostic Ultrasound Physician | 804704 | OH | Yes |

## Other

- **Enumeration date:** 08/17/2005
- **Last updated:** 12/29/2011