10D2224121 CLIA NUMBER - SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING - WINTER PARK III

Laboratory Demographics

  • CLIA Code: 10D2224121
  • Facility Name: SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING - WINTER PARK III
  • Facility Address: 1350 W FAIRBANKS AVE
    WINTER PARK, FL
    ZIP 32789
  • Facility Phone: 321 203-5730
  • Facility Type: Other - RADIOLOGY
  • Facility Type: Waiver
  • Lab Director: VIJITHA REDDY
  • NPI Number: 1043983752
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D2224121
LAB Type Other - RADIOLOGY
Facility Name SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING - WINTER PARK III
Street 1350 W FAIRBANKS AVE
City WINTER PARK
State FL
ZIP 32789
Phone 321 203-5730
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Other - RADIOLOGY
Lab Director VIJITHA REDDY

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