Organization
VIVIDLY PROFOUND LLC
Active
Other names
Vitalized Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
DESTINY HARRISTON MA (MEDICAL ASSISTANT/PHLEBOTOMIST)
(440) 561-0986
Entity
Organization
Contact information
Practice address
8210 MACEDONIA COMMONS BLVD, STE 3B #2172, MACEDONIA, OH 44056
(440) 561-0986
Mailing address
8210 MACEDONIA COMMONS BLVD, STE 3B #2172, MACEDONIA, OH 44056
(440) 561-0986
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
—
—
Other
Enumeration date
04/01/2026
Last updated
04/01/2026
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