33D1005939 CLIA NUMBER - SANJEEV GUPTA MD MUKTA GUPTA MD

Laboratory Demographics

CLIA Number: 33D1005939

Facility Name: SANJEEV GUPTA MD MUKTA GUPTA MD

Facility Address:
31 HOSPITAL DRIVE
MASSENA, NY
ZIP 13662
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Facility Phone Number: 315 769-1099

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1558360693

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

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
CertificateType	4
CertificateEffectiveDate	11/4/2022
CertificateExpirationDate	11/3/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024