Organization Active NPI

Vital Lab, LLC

  • Clinical Medical Laboratory
  • Portsmouth, VA
National Provider Identifier
1710588074
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
VITAL LAB, LLC
Practice address
355 Crawford St Ste 512
Portsmouth, VA 23704-2816
Phone
(757) 971-1460
Fax
(757) 594-1460
NPI assigned
Nov 3, 2020
Last updated
Apr 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Authorized official

Name
Laquanda Caldwell
Title
Laboratory Director
Phone
(757) 971-1460

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

355 Crawford St Ste 512
Portsmouth, VA 23704-2816

Mailing address

355 Crawford St Ste 512
Portsmouth, VA 23704-2816
Phone (757) 971-1460

Other identifiers 1

IdentifierTypeStateIssuer
49D2199943OtherVACLIA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2199943Vital Lab355 Crawford St, Suite 512, Portsmouth, VA 23704Certificate of waiverNov 11, 2026

National Provider Directory

National Provider Directory

Locations

355 Crawford St
Ste 512
Portsmouth, VA 23704
Phone (757) 971-1460

NPI Registry JSON

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775433600000",
    "number": "1710588074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 CRAWFORD ST STE 512",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237042816",
            "telephone_number": "757-971-1460",
            "fax_number": "757-594-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 CRAWFORD ST STE 512",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237042816",
            "telephone_number": "757-971-1460",
            "fax_number": "757-594-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL LAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-03",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "LAQUANDA",
        "authorized_official_title_or_position": "LABORATORY DIRECTOR",
        "authorized_official_telephone_number": "757-971-1460"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "49D2199943",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.