| Vital Lab, Llc | |
|
355 Crawford St Ste 512 Portsmouth VA 23704-2816 | |
| (757) 971-1460 | |
| (757) 594-1460 |
| Full Name | Vital Lab, Llc |
|---|---|
| Speciality | Clinical Medical Laboratory |
| Location | 355 Crawford St Ste 512, Portsmouth, Virginia |
| Authorized Official Name and Position | Laquanda Caldwell (LABORATORY DIRECTOR) |
| Authorized Official Contact | 7579711460 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Lab, Llc 355 Crawford St Ste 512 Portsmouth VA 23704-2816 Ph: (757) 971-1460 | Vital Lab, Llc 355 Crawford St Ste 512 Portsmouth VA 23704-2816 Ph: (757) 971-1460 |
| NPI Number | 1710588074 |
|---|---|
| Provider Enumeration Date | 11/03/2020 |
| Last Update Date | 04/06/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710588074 | NPI | - | NPPES |
| 49D2199943 | Other | VA | CLIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 291U00000X | Clinical Medical Laboratory | (* (Not Available)) | Primary |
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