10D2161545 CLIA NUMBER - SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING - ST PETERSBURG

Laboratory Demographics

  • CLIA Code: 10D2161545
  • Facility Name: SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING - ST PETERSBURG
  • Facility Address: 840 DR MLK JR ST NORTH - STE 100
    SAINT PETERSBURG, FL
    ZIP 33705
  • Facility Phone: 727 440-8250
  • Facility Type: Other - OUTPATIENT MED IMAGING
  • Facility Type: Waiver
  • Lab Director: VIJITHA K. REDDY
  • NPI Number: 1538739479
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D2161545
LAB Type Other - OUTPATIENT MED IMAGING
Facility Name SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING - ST PETERSBURG
Street 840 DR MLK JR ST NORTH - STE 100
City SAINT PETERSBURG
State FL
ZIP 33705
Phone 727 440-8250
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