03D2132725 CLIA NUMBER - SMI IMAGING, LLC DBA SIMONMED IMAGING - STAND UP OPEN MRI

Laboratory Demographics

  • CLIA Code: 03D2132725
  • Facility Name: SMI IMAGING, LLC DBA SIMONMED IMAGING - STAND UP OPEN MRI
  • Facility Address: 1110 E MISSOURI AVE STE 410
    PHOENIX, AZ
    ZIP 85014
  • Facility Phone: 602 274-4674
  • Facility Type: Other - OUTPATIENT RADIOLOGY
  • Facility Type: Waiver
  • Lab Director: HOWARD J. SIMON
  • NPI Number: 1831795756
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 03D2132725
LAB Type Other - OUTPATIENT RADIOLOGY
Facility Name SMI IMAGING, LLC DBA SIMONMED IMAGING - STAND UP OPEN MRI
Street 1110 E MISSOURI AVE STE 410
City PHOENIX
State AZ
ZIP 85014
Phone 602 274-4674
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/27/2023
Certificate Expiration Date 6/26/2025
Facility Type Other - OUTPATIENT RADIOLOGY
Lab Director HOWARD J. SIMON

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