Vitalant

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

50D0661599 Issued in WA

Legal business name

VITALANT

Practice address

210 W Cataldo Ave
Spokane, WA 99201-2217

Phone

(509) 624-0151

Fax

(509) 232-4528

NPI assigned

Jan 23, 2013

Organization subpart

No

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

Authorized official

Name

Bhavi A Shah

Title

Chief Legal & Risk Officer

Phone

(480) 675-5653

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Vitalant

  • Clinical Medical Laboratory
  • Pittsburgh, PA
  • NPI 1306489323

  2961630058

  Same PAC ID

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

CLIA laboratory certificates

Tax ID family

DRS Simon and Smith5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Vitalant

  • Clinical Medical Laboratory
  • Pittsburgh, PA
  • NPI 1306489323
  NPD tax ID
• Vitalant

  • Clinical Medical Laboratory
  • Mather, CA
  • NPI 1548489024
  NPD tax ID
• Vitalant

  • Blood Bank
  • Scottsdale, AZ
  • NPI 1558643064
  NPD tax ID
• Vitalant

  • Clinical Medical Laboratory
  • Phoenix, AZ
  • NPI 1588711592
  NPD tax ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Vitalant

  • Clinical Medical Laboratory
  • Mather, CA
  • NPI 1578003380

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759881600000",
    "number": "1992043152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W CATALDO AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012217",
            "telephone_number": "509-624-0151",
            "fax_number": "509-232-4528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W CATALDO AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012217",
            "telephone_number": "509-624-0151",
            "fax_number": "509-232-4528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALANT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-23",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "BHAVI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF LEGAL & RISK OFFICER",
        "authorized_official_telephone_number": "480-675-5653"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WA",
            "license": "50D0661599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "50HL02",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Visintainer
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• Julia Vladimirovna Vistorovskaya
• Yana Vistorovskaya
• Nancy L Vitello Mikiska, PAC
• Vivian Moise MD PC
• Nicolle Lee Vivit, BA
• Gregory Christopher Vixama
• Konstantin Vlasov

• Clinical Medical Laboratory in Spokane, WA
• Providers in Spokane, WA by specialty
• Clinical Medical Laboratory in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; 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.