Organization
VITAL LABS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAKHRA SHAFI (MANAGING DIRECTOR)
(773) 654-3069
Entity
Organization
Contact information
Practice address
4176 W MONTROSE AVE, CHICAGO, IL 60641-2161
(773) 654-3069
Mailing address
4176 W MONTROSE AVE, CHICAGO, IL 60641-2161
(773) 654-3069
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
09/21/2020
Last updated
10/12/2020
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