Provider Demographics
NPI:1962814665
Name:VISIONGATE BIOSIGNATURE LABRATORIES, LLC
Entity Type:Organization
Organization Name:VISIONGATE BIOSIGNATURE LABRATORIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCARLETT
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-368-2023
Mailing Address - Street 1:275 N GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-1700
Mailing Address - Country:US
Mailing Address - Phone:602-368-2023
Mailing Address - Fax:602-368-9197
Practice Address - Street 1:275 N GATEWAY DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-1700
Practice Address - Country:US
Practice Address - Phone:602-368-2023
Practice Address - Fax:602-368-9197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory