10D2263191 CLIA NUMBER - SIMONMED IMAGING FLORIDA DBA SIMONMED IMAGING- CARROLLWOOD

Laboratory Demographics

CLIA Number: 10D2263191

Facility Name: SIMONMED IMAGING FLORIDA DBA SIMONMED IMAGING- CARROLLWOOD

Facility Address:
10010 N DALE MABRY HWY STE 150
TAMPA, FL
ZIP 33618
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Facility Phone Number: 813 964-8439

Facility Type: Other - OUTPATIENT MEDICAL IMAGIN

Certificate Type: Waiver

NPI Number: 1689317497

Taxonomy: 2085R0202X - Radiology
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

CLIA Record

Field Name	Field Value
CLIA Number	10D2263191
LAB Type	Other - OUTPATIENT MEDICAL IMAGIN
Facility Name	SIMONMED IMAGING FLORIDA DBA SIMONMED IMAGING- CARROLLWOOD
Street	10010 N DALE MABRY HWY STE 150
City	TAMPA
State	FL
ZIP	33618
Phone	813 964-8439
CertificateType	4
CertificateEffectiveDate	6/24/2022
CertificateExpirationDate	6/23/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024