39D0941448 CLIA NUMBER - RUSSELLTON MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 39D0941448
  • Facility Name: RUSSELLTON MEDICAL GROUP
  • Facility Address: ONE ALEXANDER CENTER SUITE 201 2585 FREEPORT ROAD
    PITTSBURGH, PA
    ZIP 15238
  • Facility Phone: 412 826-8840
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. GOPI RAJUPET
  • NPI Number: 1063554079
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 39D0941448
LAB Type Physician Office
Facility Name RUSSELLTON MEDICAL GROUP
Street ONE ALEXANDER CENTER SUITE 201 2585 FREEPORT ROAD
City PITTSBURGH
State PA
ZIP 15238
Phone 412 826-8840
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 DR. GOPI RAJUPET

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