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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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