Organization
VITALITY DX LLC
Active
Other names
Sphere DX
Organization subpart
No
Provider details
NPI number
Authorized official
TAMIA FISHER (CREDENTIALING)
(812) 962-7894
Entity
Organization
Contact information
Practice address
2277 THUNDERSTICK DR STE 200, LEXINGTON, KY 40505-4882
(502) 830-9503
Mailing address
7145 E VIRGINIA ST STE 2000, EVANSVILLE, IN 47715-9147
(812) 962-7894
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18D2200531
CLIA
KY
05
—
7100719120
—
KY
Enumeration date
11/10/2020
Last updated
11/14/2022
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