10D0979568 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP, LLC

Laboratory Demographics

  • CLIA Code: 10D0979568
  • Facility Name: MILLENNIUM PHYSICIAN GROUP, LLC
  • Facility Address: 2004 W THONOTOSASSA RD - STE 101
    PLANT CITY, FL
    ZIP 33563
  • Facility Phone: 941 787-7665
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CYNTHIA CORTES
  • NPI Number: 1396765939
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0979568
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP, LLC
Street 2004 W THONOTOSASSA RD - STE 101
City PLANT CITY
State FL
ZIP 33563
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 10/25/2024
Certificate Expiration Date 10/24/2026
Facility Type Physician Office
Lab Director CYNTHIA CORTES

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