MEDICARE: VITAL TESTING SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	36D2248553	OTHER	OH	CLIA LAB

General Provider Information

NPI Number	:	1912650441
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL TESTING SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	4443 READING RD STE 203
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-1252
Country	:	US
Telephone Number	:	513-889-8894
Fax Number	:

Provider Business Practice Location Address
First Line	:	4443 READING RD STE 203
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45229-1252
Country	:	US
Telephone Number	:	513-889-8894
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	MRS. LATONYA SANDERS
Credential	:	RN
Telephone Number	:	513-889-8894

Provider Enumeration Date	:	02/03/2022
Last Update Date	:	02/03/2022

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Directions to “VITAL TESTING SOLUTIONS LLC ” Practice Location

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