05D0860885 CLIA NUMBER - PRAVEEN GUPTA MD INC

Laboratory Demographics

  • CLIA Code: 05D0860885
  • Facility Name: PRAVEEN GUPTA MD INC
  • Facility Address: 9435 VENICE BOULEVARD
    CULVER CITY, CA
    ZIP 90232
  • Facility Phone: 310 559-0575
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PRAVEEN GUPTA MD
  • NPI Number: 1649386707
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 05D0860885
LAB Type Physician Office
Facility Name PRAVEEN GUPTA MD INC
Street 9435 VENICE BOULEVARD
City CULVER CITY
State CA
ZIP 90232
Phone 310 559-0575
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/11/2025
Certificate Expiration Date 10/10/2027
Facility Type Physician Office
Lab Director PRAVEEN GUPTA MD

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