10D2050737 CLIA NUMBER - SIMONMED IMAGING SAND LAKE

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Laboratory Demographics

CLIA Number: 10D2050737

Facility Name: SIMONMED IMAGING SAND LAKE

Facility Address:
6000 TURKEY LAKE RD STE 107
ORLANDO, FL
ZIP 32819
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Facility Phone Number: 407 264-7160

Facility Type: Other - MEDICAL RADIOLOGY

Certificate Type: Waiver

NPI Number: 1891365888

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	10D2050737
LAB Type	Other - MEDICAL RADIOLOGY
Facility Name	SIMONMED IMAGING SAND LAKE
Street	6000 TURKEY LAKE RD STE 107
City	ORLANDO
State	FL
ZIP	32819
Phone	407 264-7160
CertificateType	4
CertificateEffectiveDate	12/5/2022
CertificateExpirationDate	12/4/2024
FacilityType	Waiver

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