10D1088558 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP LLC

Laboratory Demographics

  • CLIA Code: 10D1088558
  • Facility Name: MILLENNIUM PHYSICIAN GROUP LLC
  • Facility Address: 19531 COCHRAN BLVD
    PORT CHARLOTTE, FL
    ZIP 33948
  • Facility Phone: 941 764-1880
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID L. MCATEE
  • NPI Number: 1124790910
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1088558
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP LLC
Street 19531 COCHRAN BLVD
City PORT CHARLOTTE
State FL
ZIP 33948
Phone 941 764-1880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2025
Certificate Expiration Date 7/31/2027
Facility Type Physician Office
Lab Director DAVID L. MCATEE

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