Organization
VITALANT
Active
Other names
BloodSource
Organization subpart
No
Provider details
NPI number
Authorized official
BHAVI A SHAH (CHIEF LEGAL & RISK OFFICER)
(480) 675-5653
Entity
Organization
Contact information
Practice address
10536 PETER A MCCUEN BLVD, MATHER, CA 95655-4128
(602) 343-7127
(916) 366-2546
Mailing address
9305 E VIA DE VENTURA, SCOTTSDALE, AZ 85258-3597
(480) 675-5696
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
02/27/2017
Last updated
10/08/2025
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