03D2025888 CLIA NUMBER - SMI IMAGING LLC DBA SIMONMED IMAGING - ORANGE GROVE

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Laboratory Demographics

CLIA Number: 03D2025888

Facility Name: SMI IMAGING LLC DBA SIMONMED IMAGING - ORANGE GROVE

Facility Address:
1845 W ORANGE GROVE RD SUITE 103
TUCSON, AZ
ZIP 85704
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Facility Phone Number: 520 230-4900

Facility Type: Other - OUTPATIENT RADIOLOGY

Certificate Type: Waiver

NPI Number: 1083971741

Taxonomy: 2085R0202X - Radiology
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

CLIA Record

Field Name	Field Value
CLIA Number	03D2025888
LAB Type	Other - OUTPATIENT RADIOLOGY
Facility Name	SMI IMAGING LLC DBA SIMONMED IMAGING - ORANGE GROVE
Street	1845 W ORANGE GROVE RD SUITE 103
City	TUCSON
State	AZ
ZIP	85704
Phone	520 230-4900
CertificateType	4
CertificateEffectiveDate	6/20/2023
CertificateExpirationDate	6/19/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024