10D2217328 CLIA NUMBER - SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING-FLEMING ISLAND

Laboratory Demographics

  • CLIA Code: 10D2217328
  • Facility Name: SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING-FLEMING ISLAND
  • Facility Address: 1685 EAGLE HARBOR PKWY
    FLEMING ISLAND, FL
    ZIP 32003
  • Facility Phone: 904 595-2010
  • Facility Type: Other - OUTPATIENT MEDICAL IMAGIN
  • Facility Type: Waiver
  • Lab Director: VIJITHA REDDY
  • NPI Number: 1740850718
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D2217328
LAB Type Other - OUTPATIENT MEDICAL IMAGIN
Facility Name SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING-FLEMING ISLAND
Street 1685 EAGLE HARBOR PKWY
City FLEMING ISLAND
State FL
ZIP 32003
Phone 904 595-2010
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 - OUTPATIENT MEDICAL IMAGIN
Lab Director VIJITHA REDDY

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