33D0892440 CLIA NUMBER - ROM M GUPTA MD

Laboratory Demographics

  • CLIA Code: 33D0892440
  • Facility Name: ROM M GUPTA MD
  • Facility Address: 175-61 HILLSIDE AVE SUITE 402
    JAMAICA EST, NY
    ZIP 11432
  • Facility Phone: 516 330-6615
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ROM M. GUPTA
  • NPI Number: 1013992528
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D0892440
LAB Type Physician Office
Facility Name ROM M GUPTA MD
Street 175-61 HILLSIDE AVE SUITE 402
City JAMAICA EST
State NY
ZIP 11432
Phone 516 330-6615
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2024
Certificate Expiration Date 9/28/2026
Facility Type Physician Office
Lab Director DR. ROM M. GUPTA

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