45D0938302 CLIA NUMBER - RAJEEV GUPTA MD

Laboratory Demographics

  • CLIA Code: 45D0938302
  • Facility Name: RAJEEV GUPTA MD
  • Facility Address: 489 AGNES ST, SUITE 100
    BASTROP, TX
    ZIP 78602
  • Facility Phone: 512 321-9091
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAJEEV GUPTA MD
  • NPI Number: 1417936261
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D0938302
LAB Type Physician Office
Facility Name RAJEEV GUPTA MD
Street 489 AGNES ST, SUITE 100
City BASTROP
State TX
ZIP 78602
Phone 512 321-9091
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/5/2024
Certificate Expiration Date 1/4/2026
Facility Type Physician Office
Lab Director RAJEEV GUPTA MD

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