03D1098120 CLIA NUMBER - SIMONMED IMAGING - BAYWOOD

Laboratory Demographics

  • CLIA Code: 03D1098120
  • Facility Name: SIMONMED IMAGING - BAYWOOD
  • Facility Address: 130 S 63RD STREET SUITE 123
    MESA, AZ
    ZIP 85206
  • Facility Phone: 480 264-4900
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: HOWARD J. SIMON, MD
  • NPI Number: 1801029103
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 03D1098120
LAB Type Other
Facility Name SIMONMED IMAGING - BAYWOOD
Street 130 S 63RD STREET SUITE 123
City MESA
State AZ
ZIP 85206
Phone 480 264-4900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2025
Certificate Expiration Date 1/5/2027
Facility Type Other
Lab Director HOWARD J. SIMON, MD

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This page was last updated on: 3/20/2025