03D1098121 CLIA NUMBER - SIMONMED IMAGING - PRESCOTT VALLEY

Laboratory Demographics

  • CLIA Code: 03D1098121
  • Facility Name: SIMONMED IMAGING - PRESCOTT VALLEY
  • Facility Address: 3033 N WINDSONG DRIVE STE #102/103
    PRESCOTT VALLEY, AZ
    ZIP 86314
  • Facility Phone: 928 772-5250
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: HOWARD J. SIMON, MD
  • NPI Number: 1124340013
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 03D1098121
LAB Type Other
Facility Name SIMONMED IMAGING - PRESCOTT VALLEY
Street 3033 N WINDSONG DRIVE STE #102/103
City PRESCOTT VALLEY
State AZ
ZIP 86314
Phone 928 772-5250
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2025
Certificate Expiration Date 4/12/2027
Facility Type Other
Lab Director HOWARD J. SIMON, MD

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