10D2254508 CLIA NUMBER - SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING- LAKEWOOD RANCH

Laboratory Demographics

  • CLIA Code: 10D2254508
  • Facility Name: SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING- LAKEWOOD RANCH
  • Facility Address: 10910 STATE RD 70 E STE 103
    LAKEWOOD RANCH, FL
    ZIP 34202
  • Facility Phone: 941 954-1900
  • Facility Type: Other - OUTPATIENT MEDICAL IMAGIN
  • Facility Type: Waiver
  • Lab Director: VIJITHA K. REDDY
  • NPI Number: 1639849318
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D2254508
LAB Type Other - OUTPATIENT MEDICAL IMAGIN
Facility Name SIMONMED IMAGING FLORIDA LLC DBA SIMONMED IMAGING- LAKEWOOD RANCH
Street 10910 STATE RD 70 E STE 103
City LAKEWOOD RANCH
State FL
ZIP 34202
Phone 941 954-1900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/4/2024
Certificate Expiration Date 3/3/2026
Facility Type Other - OUTPATIENT MEDICAL IMAGIN
Lab Director VIJITHA K. REDDY

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