10D2152694 CLIA NUMBER - SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING - LEESBURG

Laboratory Demographics

CLIA Number: 10D2152694

Facility Name: SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING - LEESBURG

Facility Address:
211 N 1ST STREET
LEESBURG, FL
ZIP 34748
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Facility Phone Number: 352 435-0111

Facility Type: Other - MEDICAL IMAGING

Certificate Type: Waiver

NPI Number: 1265002240

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	10D2152694
LAB Type	Other - MEDICAL IMAGING
Facility Name	SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING - LEESBURG
Street	211 N 1ST STREET
City	LEESBURG
State	FL
ZIP	34748
Phone	352 435-0111
CertificateType	4
CertificateEffectiveDate	8/14/2022
CertificateExpirationDate	8/13/2024
FacilityType	Waiver

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