10D2163629 CLIA NUMBER - SIMONMED IMAGING FLORIDA, LLC DBA SIMONMED IMAGING - SARASOTA

Laboratory Demographics

  • CLIA Code: 10D2163629
  • Facility Name: SIMONMED IMAGING FLORIDA, LLC DBA SIMONMED IMAGING - SARASOTA
  • Facility Address: 6250 LAKE OSPREY DR, STE 100
    LAKEWOOD RANCH, FL
    ZIP 34240
  • Facility Phone: 941 957-9340
  • Facility Type: Other - OP MEDICAL IMAGING
  • Facility Type: Waiver
  • Lab Director: VIJITHA K. REDDY
  • NPI Number: 1053981027
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D2163629
LAB Type Other - OP MEDICAL IMAGING
Facility Name SIMONMED IMAGING FLORIDA, LLC DBA SIMONMED IMAGING - SARASOTA
Street 6250 LAKE OSPREY DR, STE 100
City LAKEWOOD RANCH
State FL
ZIP 34240
Phone 941 957-9340
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2025
Certificate Expiration Date 3/18/2027
Facility Type Other - OP MEDICAL IMAGING
Lab Director VIJITHA K. REDDY

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