10D0962524 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP

Laboratory Demographics

  • CLIA Code: 10D0962524
  • Facility Name: MILLENNIUM PHYSICIAN GROUP
  • Facility Address: 1885 ENGLEWOOD ROAD
    ENGLEWOOD, FL
    ZIP 34223
  • Facility Phone: 941 787-7665
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KAREN BASSETTI
  • NPI Number: 1457023210
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D0962524
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP
Street 1885 ENGLEWOOD ROAD
City ENGLEWOOD
State FL
ZIP 34223
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 7/7/2025
Certificate Expiration Date 7/6/2027
Facility Type Physician Office
Lab Director KAREN BASSETTI

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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