10D0914944 CLIA NUMBER - MILLENNIUM PHYSICAN GROUP, LLC

Laboratory Demographics

  • CLIA Code: 10D0914944
  • Facility Name: MILLENNIUM PHYSICAN GROUP, LLC
  • Facility Address: 260 BETH STACEY BLVD STE 130
    LEHIGH ACRES, FL
    ZIP 33936
  • Facility Phone: 941 787-7665
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHIKHA SHRESTHA
  • NPI Number: 1811290190
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0914944
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICAN GROUP, LLC
Street 260 BETH STACEY BLVD STE 130
City LEHIGH ACRES
State FL
ZIP 33936
Phone 941 787-7665
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2024
Certificate Expiration Date 5/14/2026
Facility Type Physician Office
Lab Director SHIKHA SHRESTHA

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