03D2154090 CLIA NUMBER - SMI IMAGING, LLC DBA SIMONMED IMAGING - FLAGSTAFF

Laboratory Demographics

  • CLIA Code: 03D2154090
  • Facility Name: SMI IMAGING, LLC DBA SIMONMED IMAGING - FLAGSTAFF
  • Facility Address: 1000 N HUMPHREYS ST SUITE 100, 101, 102
    FLAGSTAFF, AZ
    ZIP 86001
  • Facility Phone: 602 320-3344
  • Facility Type: Other - OUTPATIENT IMAGING
  • Facility Type: Waiver
  • Lab Director: HOWARD J. SIMON
  • NPI Number: 1245836154
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 03D2154090
LAB Type Other - OUTPATIENT IMAGING
Facility Name SMI IMAGING, LLC DBA SIMONMED IMAGING - FLAGSTAFF
Street 1000 N HUMPHREYS ST SUITE 100, 101, 102
City FLAGSTAFF
State AZ
ZIP 86001
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: 9/29/2025