03D1088522 CLIA NUMBER - SMI IMAGING LLC DBA SIMONMED IMAGING - PEORIA PLAZA

Laboratory Demographics

  • CLIA Code: 03D1088522
  • Facility Name: SMI IMAGING LLC DBA SIMONMED IMAGING - PEORIA PLAZA
  • Facility Address: 9139 W THUNDERBIRD RD, STE 112
    PEORIA, AZ
    ZIP 85381
  • Facility Phone: 623 875-1637
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: HOWARD J. SIMON
  • NPI Number: 1376149898
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 03D1088522
LAB Type Other
Facility Name SMI IMAGING LLC DBA SIMONMED IMAGING - PEORIA PLAZA
Street 9139 W THUNDERBIRD RD, STE 112
City PEORIA
State AZ
ZIP 85381
Phone 623 875-1637
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2024
Certificate Expiration Date 8/26/2026
Facility Type Other
Lab Director HOWARD J. SIMON

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