38D2083020 CLIA NUMBER - CENTENNIAL KIDNEY ASSOCIATES

Laboratory Demographics

  • CLIA Code: 38D2083020
  • Facility Name: CENTENNIAL KIDNEY ASSOCIATES
  • Facility Address: 2460 STEWART PARKWAY SUITE 102
    ROSEBURG, OR
    ZIP 97471
  • Facility Phone: 541 677-3642
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANJALI GUPTA MD
  • NPI Number: 1245547744
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 38D2083020
LAB Type Physician Office
Facility Name CENTENNIAL KIDNEY ASSOCIATES
Street 2460 STEWART PARKWAY SUITE 102
City ROSEBURG
State OR
ZIP 97471
Phone 541 677-3642
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2024
Certificate Expiration Date 8/25/2026
Facility Type Physician Office
Lab Director ANJALI GUPTA MD

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