Organization
VITAL LIFE LAB SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASELA MOYA (MANAGING MEMBER)
(309) 309-3432
Entity
Organization
Contact information
Practice address
2501 CHATHAM RD STE N, SPRINGFIELD, IL 62704-4188
(309) 309-3432
Mailing address
2501 CHATHAM RD STE N, SPRINGFIELD, IL 62704-4188
(309) 309-3432
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
02/04/2026
Last updated
02/04/2026
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