33D1005939 CLIA NUMBER - SANJEEV GUPTA MD MUKTA GUPTA MD

Laboratory Demographics

  • CLIA Code: 33D1005939
  • Facility Name: SANJEEV GUPTA MD MUKTA GUPTA MD
  • Facility Address: 31 HOSPITAL DRIVE
    MASSENA, NY
    ZIP 13662
  • Facility Phone: 315 769-1099
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MUKTA GUPTA
  • NPI Number: 1558360693
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 33D1005939
LAB Type Physician Office
Facility Name SANJEEV GUPTA MD MUKTA GUPTA MD
Street 31 HOSPITAL DRIVE
City MASSENA
State NY
ZIP 13662
Phone 315 769-1099
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/4/2024
Certificate Expiration Date 11/3/2026
Facility Type Physician Office
Lab Director MUKTA GUPTA

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