05D2149127 CLIA NUMBER - SIMI MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 05D2149127
  • Facility Name: SIMI MEDICAL GROUP INC
  • Facility Address: 2755 ALAMO ST STE 101
    SIMI VALLEY, CA
    ZIP 93065
  • Facility Phone: 805 210-7280
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RICHARD M. SHAW
  • NPI Number: 1346768025
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2149127
LAB Type Physician Office
Facility Name SIMI MEDICAL GROUP INC
Street 2755 ALAMO ST STE 101
City SIMI VALLEY
State CA
ZIP 93065
Phone 805 210-7280
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 5/24/2024
Certificate Expiration Date 5/23/2026
Facility Type Physician Office
Lab Director RICHARD M. SHAW

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This page was last updated on: 9/29/2025