10D0989857 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP

Laboratory Demographics

  • CLIA Code: 10D0989857
  • Facility Name: MILLENNIUM PHYSICIAN GROUP
  • Facility Address: 1351 13TH AVE SOUTH STE 110
    JACKSONVILLE BEACH, FL
    ZIP 32250
  • Facility Phone: 941 787-7665
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHARMAINE AGUIRRE
  • NPI Number: 1417629106
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0989857
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP
Street 1351 13TH AVE SOUTH STE 110
City JACKSONVILLE BEACH
State FL
ZIP 32250
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 8/8/2025
Certificate Expiration Date 8/7/2027
Facility Type Physician Office
Lab Director CHARMAINE AGUIRRE

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