10D2161539 CLIA NUMBER - SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING-BRANDON

Laboratory Demographics

  • CLIA Code: 10D2161539
  • Facility Name: SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING-BRANDON
  • Facility Address: 613 OAKFIELD DR
    BRANDON, FL
    ZIP 33511
  • Facility Phone: 602 688-6116
  • Facility Type: Other - OUTPATIENT MED IMAGING
  • Facility Type: Waiver
  • Lab Director: VIJITHA K. REDDY
  • NPI Number: 1063041655
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D2161539
LAB Type Other - OUTPATIENT MED IMAGING
Facility Name SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING-BRANDON
Street 613 OAKFIELD DR
City BRANDON
State FL
ZIP 33511
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 2/5/2025
Certificate Expiration Date 2/4/2027
Facility Type Other - OUTPATIENT MED IMAGING
Lab Director VIJITHA K. REDDY

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