10D1096067 CLIA NUMBER - SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING-PARK BLVD

Laboratory Demographics

  • CLIA Code: 10D1096067
  • Facility Name: SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING-PARK BLVD
  • Facility Address: 4800 PARK BLVD N
    PINELLAS PARK, FL
    ZIP 33781
  • Facility Phone: (727) 525-2121
  • Facility Type: Other - OP MEDICAL IMAGING
  • Facility Type: Waiver
  • Lab Director: VIJITHA K. REDDY
  • NPI Number: 1720778780
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D1096067
LAB Type Other - OP MEDICAL IMAGING
Facility Name SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING-PARK BLVD
Street 4800 PARK BLVD N
City PINELLAS PARK
State FL
ZIP 33781
Phone 7275252121
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/25/2025
Certificate Expiration Date 2/24/2027
Facility Type Other - OP MEDICAL IMAGING
Lab Director VIJITHA K. REDDY

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This page was last updated on: 5/18/2026