Organization
VITALITY CLINICAL LABORATORIES PLLC
Active
Organization
VITALITY CLINICAL LABORATORIES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES BENJAMIN EVANS II M.D. (LABORATORY DIRECTOR)
(602) 791-9112
Entity
Organization
Contact information
Practice address
4643 N 12TH ST, STE 101, PHOENIX, AZ 85014-4006
(602) 791-9112
(855) 431-7712
Mailing address
8776 E SHEA BLVD, STE B3A-129, SCOTTSDALE, AZ 85260-6629
(602) 791-9112
(855) 431-7712
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
03D2073405
AZ
Other
Enumeration date
03/11/2016
Last updated
03/11/2016
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