03D1074758 CLIA NUMBER - SMI IMAGING LLC DBA SIMONMED IMAGING - AHWATUKEE

Laboratory Demographics

  • CLIA Code: 03D1074758
  • Facility Name: SMI IMAGING LLC DBA SIMONMED IMAGING - AHWATUKEE
  • Facility Address: 15810 S 45TH ST
    PHOENIX, AZ
    ZIP 85048
  • Facility Phone: 480 753-6161
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: HOWARD J. SIMON
  • NPI Number: 1508117292
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 03D1074758
LAB Type Other
Facility Name SMI IMAGING LLC DBA SIMONMED IMAGING - AHWATUKEE
Street 15810 S 45TH ST
City PHOENIX
State AZ
ZIP 85048
Phone 480 753-6161
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/16/2024
Certificate Expiration Date 5/15/2026
Facility Type Other
Lab Director HOWARD J. SIMON

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This page was last updated on: 9/29/2025