14D2171202 CLIA NUMBER - SIMONMED IMAGING - STREETERVILLE HOWARD SIMON M D, P C

Laboratory Demographics

  • CLIA Code: 14D2171202
  • Facility Name: SIMONMED IMAGING - STREETERVILLE HOWARD SIMON M D, P C
  • Facility Address: 446 E ONTARIO ST - STE 106
    CHICAGO, IL
    ZIP 60611
  • Facility Phone: 312 440-0016
  • Facility Type: Other - OUTPATIENT MED IMAGING
  • Facility Type: Waiver
  • Lab Director: HOWARD J. SIMON M D
  • NPI Number: 1659930998
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 14D2171202
LAB Type Other - OUTPATIENT MED IMAGING
Facility Name SIMONMED IMAGING - STREETERVILLE HOWARD SIMON M D, P C
Street 446 E ONTARIO ST - STE 106
City CHICAGO
State IL
ZIP 60611
Phone 312 440-0016
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2025
Certificate Expiration Date 8/26/2027
Facility Type Other - OUTPATIENT MED IMAGING
Lab Director HOWARD J. SIMON M D

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