03D1096284 CLIA NUMBER - SIMONMED IMAGING - 19TH AVE

Laboratory Demographics

  • CLIA Code: 03D1096284
  • Facility Name: SIMONMED IMAGING - 19TH AVE
  • Facility Address: 6707 N 19TH AVE, STE 108
    PHOENIX, AZ
    ZIP 85015
  • Facility Phone: 602 688-6200
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: HOWARD J. SIMON
  • NPI Number: 1811219702
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 03D1096284
LAB Type Other
Facility Name SIMONMED IMAGING - 19TH AVE
Street 6707 N 19TH AVE, STE 108
City PHOENIX
State AZ
ZIP 85015
Phone 602 688-6200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/2/2025
Certificate Expiration Date 3/1/2027
Facility Type Other
Lab Director HOWARD J. SIMON

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