10D0272664 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP

Laboratory Demographics

  • CLIA Code: 10D0272664
  • Facility Name: MILLENNIUM PHYSICIAN GROUP
  • Facility Address: 2840 SOUTHEAST 3RD CT STE 100
    OCALA, FL
    ZIP 34471
  • Facility Phone: 352 622-1777
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANTULURI RAJU
  • NPI Number: 1093487779
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0272664
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP
Street 2840 SOUTHEAST 3RD CT STE 100
City OCALA
State FL
ZIP 34471
Phone 352 622-1777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director DANTULURI RAJU

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