Vital Lab Services, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

VITAL LAB SERVICES, INC

Practice address

6439 Plymouth Ave Ste 127
Saint Louis, MO 63133-1940

Phone

(636) 465-3004

Fax

(314) 833-3170

NPI assigned

Sep 27, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shaunice Shelton, RN

Title

Director

Phone

(636) 465-3004

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1336810472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6439 PLYMOUTH AVE STE 127",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631331940",
            "telephone_number": "636-465-3004",
            "fax_number": "314-833-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6439 PLYMOUTH AVE STE 127",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631331940",
            "telephone_number": "636-465-3004",
            "fax_number": "314-833-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL LAB SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "SHELTON",
        "authorized_official_first_name": "SHAUNICE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "636-465-3004",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Humsini Viswanath
• Vitae Health Medical Missouri LLC
• Vital Essence Apothecary LLC
• Vital Force Chiropractic PC
• Vital Home Care Services LLC
• Angelina Vitale
• Chloe M Vitale, CRNA
• Jenna Marie Vitale
• Joseph Peter Vitale, DC
• Josie Vitale, M.D.

• Clinical Medical Laboratory in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Medical Laboratory in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.