10D1007497 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP LLC

Laboratory Demographics

  • CLIA Code: 10D1007497
  • Facility Name: MILLENNIUM PHYSICIAN GROUP LLC
  • Facility Address: 14171 METROPOLIS AVE - STE 101
    FORT MYERS, FL
    ZIP 33912
  • Facility Phone: (941) 787-7665
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EUCLIDES MARMOLEJOS BAEZ
  • NPI Number: 1003588849
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1007497
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP LLC
Street 14171 METROPOLIS AVE - STE 101
City FORT MYERS
State FL
ZIP 33912
Phone 9417877665
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2024
Certificate Expiration Date 12/18/2026
Facility Type Physician Office
Lab Director EUCLIDES MARMOLEJOS BAEZ

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This page was last updated on: 5/18/2026