36D2077807 CLIA NUMBER - SURESH GUPTA MD INC DBA PAIN MANAGEMENT ASSOCIATES

Laboratory Demographics

  • CLIA Code: 36D2077807
  • Facility Name: SURESH GUPTA MD INC DBA PAIN MANAGEMENT ASSOCIATES
  • Facility Address: 1010 WOODMAN DR
    DAYTON, OH
    ZIP 45432
  • Facility Phone: 937 424-2215
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PRIYESH MEHTA
  • NPI Number: 1508895640
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 36D2077807
LAB Type Physician Office
Facility Name SURESH GUPTA MD INC DBA PAIN MANAGEMENT ASSOCIATES
Street 1010 WOODMAN DR
City DAYTON
State OH
ZIP 45432
Phone 937 424-2215
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2024
Certificate Expiration Date 5/14/2026
Facility Type Physician Office
Lab Director PRIYESH MEHTA

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