10D2163630 CLIA NUMBER - SIMONMED IMAGING FLORIDA, LLC DBA SIMONMED IMAGING - MACDILL

Laboratory Demographics

  • CLIA Code: 10D2163630
  • Facility Name: SIMONMED IMAGING FLORIDA, LLC DBA SIMONMED IMAGING - MACDILL
  • Facility Address: 110 S MACDILL
    TAMPA, FL
    ZIP 33609
  • Facility Phone: 480 428-5604
  • Facility Type: Other - OP MEDICAL IMAGING
  • Facility Type: Waiver
  • Lab Director: VIJITHA REDDY
  • NPI Number: 1518537455
  • Taxonomy: 2085R0202X - Radiology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2163630
LAB Type Other - OP MEDICAL IMAGING
Facility Name SIMONMED IMAGING FLORIDA, LLC DBA SIMONMED IMAGING - MACDILL
Street 110 S MACDILL
City TAMPA
State FL
ZIP 33609
Phone 480 428-5604
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 REDDY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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