10D0682223 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP

Laboratory Demographics

  • CLIA Code: 10D0682223
  • Facility Name: MILLENNIUM PHYSICIAN GROUP
  • Facility Address: 3571 DEL PRADO BLVD
    CAPE CORAL, FL
    ZIP 33909
  • Facility Phone: 941 764-1880
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GEORGE M. MESTAS
  • NPI Number: 1821760687
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0682223
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP
Street 3571 DEL PRADO BLVD
City CAPE CORAL
State FL
ZIP 33909
Phone 941 764-1880
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 GEORGE M. MESTAS

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