Healthcare Provider Details

I. General information

NPI: 1497680136
Provider Name (Legal Business Name): VITAL LABS PHLEBOTOMY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7975 BADURA AVE STE 1005
LAS VEGAS NV
89113-2156
US

IV. Provider business mailing address

7975 BADURA AVE STE 1005
LAS VEGAS NV
89113-2156
US

V. Phone/Fax

Practice location:
  • Phone: 702-626-8747
  • Fax:
Mailing address:
  • Phone: 702-626-8747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDRIA PAJARILLO VENOYA
Title or Position: OWNER/PHLEBOTOMIST
Credential:
Phone: 702-626-8747