03D2162808 CLIA NUMBER - SMI IMAGING LLC DBA SIMONMED IMAGING - LITCHFIELD

Laboratory Demographics

CLIA Number: 03D2162808

Facility Name: SMI IMAGING LLC DBA SIMONMED IMAGING - LITCHFIELD

Facility Address:
1325 N LITCHFIELD ROAD SUITE 115
GOODYEAR, AZ
ZIP 85395
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Facility Phone Number: 602 888-6116

Facility Type: Other - OP MEDICAL IMAGING

Certificate Type: Waiver

NPI Number: 1679179154

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	03D2162808
LAB Type	Other - OP MEDICAL IMAGING
Facility Name	SMI IMAGING LLC DBA SIMONMED IMAGING - LITCHFIELD
Street	1325 N LITCHFIELD ROAD SUITE 115
City	GOODYEAR
State	AZ
ZIP	85395
Phone	602 888-6116
CertificateType	4
CertificateEffectiveDate	3/1/2023
CertificateExpirationDate	2/28/2025
FacilityType	Waiver

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