03D2154087 CLIA NUMBER - SMI IMAGING, LLC DBA SIMONMED IMAGING - MCKELLIPS

Laboratory Demographics

  • CLIA Code: 03D2154087
  • Facility Name: SMI IMAGING, LLC DBA SIMONMED IMAGING - MCKELLIPS
  • Facility Address: 1345 E MCKELLIPS RD SUITE 106
    MESA, AZ
    ZIP 85203
  • Facility Phone: 602 320-3344
  • Facility Type: Other - OUTPATIENT IMAGING
  • Facility Type: Waiver
  • Lab Director: HOWARD J. SIMON
  • NPI Number: 1104422039
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 03D2154087
LAB Type Other - OUTPATIENT IMAGING
Facility Name SMI IMAGING, LLC DBA SIMONMED IMAGING - MCKELLIPS
Street 1345 E MCKELLIPS RD SUITE 106
City MESA
State AZ
ZIP 85203
Phone 602 320-3344
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/6/2024
Certificate Expiration Date 9/5/2026
Facility Type Other - OUTPATIENT IMAGING
Lab Director HOWARD J. SIMON

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