21D2119652 CLIA NUMBER - GHANSHYAM GUPTA MD

Laboratory Demographics

  • CLIA Code: 21D2119652
  • Facility Name: GHANSHYAM GUPTA MD
  • Facility Address: 10110 MOLECULAR DRIVE, SUITE 104
    ROCKVILLE, MD
    ZIP 20850
  • Facility Phone: 301 838-4224
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: ANANDITA A. DATTA
  • NPI Number: 1619089000
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D2119652
LAB Type Physician Office
Facility Name GHANSHYAM GUPTA MD
Street 10110 MOLECULAR DRIVE, SUITE 104
City ROCKVILLE
State MD
ZIP 20850
Phone 301 838-4224
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 3/13/2024
Certificate Expiration Date 3/12/2026
Facility Type Physician Office
Lab Director ANANDITA A. DATTA

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