14D0930249 CLIA NUMBER - ANIL GUPTA MD

Laboratory Demographics

  • CLIA Code: 14D0930249
  • Facility Name: ANIL GUPTA MD
  • Facility Address: 421 S MAIN ST
    COLUMBIA, IL
    ZIP 62236
  • Facility Phone: 618 281-7151
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANIL GUPTA MD
  • NPI Number: 1912961558
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 14D0930249
LAB Type Physician Office
Facility Name ANIL GUPTA MD
Street 421 S MAIN ST
City COLUMBIA
State IL
ZIP 62236
Phone 618 281-7151
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2025
Certificate Expiration Date 6/30/2027
Facility Type Physician Office
Lab Director ANIL GUPTA MD

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