10D2132322 CLIA NUMBER - SIMON MED IMAGING - CLERMONT

Laboratory Demographics

CLIA Number: 10D2132322

Facility Name: SIMON MED IMAGING - CLERMONT

Facility Address:
265 CITRUS TOWER BLVD STE 100
CLERMONT, FL
ZIP 34711
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Facility Phone Number: 602 320-3344

Facility Type: Other - OUTPATIENT MEDICAL IMAGIN

Certificate Type: Waiver

NPI Number: 1528638509

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	10D2132322
LAB Type	Other - OUTPATIENT MEDICAL IMAGIN
Facility Name	SIMON MED IMAGING - CLERMONT
Street	265 CITRUS TOWER BLVD STE 100
City	CLERMONT
State	FL
ZIP	34711
Phone	602 320-3344
CertificateType	4
CertificateEffectiveDate	6/16/2023
CertificateExpirationDate	6/15/2025
FacilityType	Waiver

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