10D1080123 CLIA NUMBER - SIMONMED IMAGING WATERFORD LAKES

Laboratory Demographics

  • CLIA Code: 10D1080123
  • Facility Name: SIMONMED IMAGING WATERFORD LAKES
  • Facility Address: 775 N ALFAYA TRL
    ORLANDO, FL
    ZIP 32828
  • Facility Phone: 602 688-6116
  • Facility Type: Other - MEDICAL RADIOLOGY
  • Facility Type: Waiver
  • Lab Director: VIJITHA K. REDDY
  • NPI Number: 1619547601
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D1080123
LAB Type Other - MEDICAL RADIOLOGY
Facility Name SIMONMED IMAGING WATERFORD LAKES
Street 775 N ALFAYA TRL
City ORLANDO
State FL
ZIP 32828
Phone 602 688-6116
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2024
Certificate Expiration Date 2/13/2026
Facility Type Other - MEDICAL RADIOLOGY
Lab Director VIJITHA K. REDDY

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